| Mosaic Pathway Counseling, Inc | |
|
1800 Nations Dr Ste 111 Gurnee IL 60031-9170 | |
| (847) 710-0612 | |
| Not Available |
| Full Name | Mosaic Pathway Counseling, Inc |
|---|---|
| Speciality | Counselor |
| Location | 1800 Nations Dr Ste 111, Gurnee, Illinois |
| Authorized Official Name and Position | Scott E Stolarick (OWNER) |
| Authorized Official Contact | 8477100612 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Pathway Counseling, Inc 1800 Nations Dr Ste 111 Gurnee IL 60031-9170 Ph: (847) 710-0612 | Mosaic Pathway Counseling, Inc 1800 Nations Dr Ste 111 Gurnee IL 60031-9170 Ph: (847) 710-0612 |
| NPI Number | 1972286862 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 08/29/2023 |
| Certification Date | 08/29/2023 |
| Medicare PECOS PAC ID | 7315398542 |
|---|---|
| Medicare Enrollment ID | O20240111003036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972286862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Scott Stolarick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427130590 PECOS PAC ID: 7214388446 Enrollment ID: I20240111003250 |
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