| Obsidian Behavioral Health Pllc | |
|
103 N 11th Ave Ste 106 Saint Charles IL 60174-2278 | |
| (630) 296-4169 | |
| (630) 296-9921 |
| Full Name | Obsidian Behavioral Health Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 103 N 11th Ave Ste 106, Saint Charles, Illinois |
| Authorized Official Name and Position | Lindsey Kovalik Bianchini (OWNER) |
| Authorized Official Contact | 6302964169 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Obsidian Behavioral Health Pllc 103 N 11th Ave Ste 106 St Charles IL 60174-2278 Ph: (630) 296-4169 | Obsidian Behavioral Health Pllc 103 N 11th Ave Ste 106 Saint Charles IL 60174-2278 Ph: (630) 296-4169 |
| NPI Number | 1841873577 |
|---|---|
| Provider Enumeration Date | 04/30/2021 |
| Last Update Date | 08/23/2024 |
| Certification Date | 08/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841873577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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