| Optum Behavioral Care Therapy Services Of Illinois Pc | |
|
6392 Linden Rd Rockford IL 61109-2816 | |
| (779) 368-0060 | |
| (779) 368-0579 |
| Full Name | Optum Behavioral Care Therapy Services Of Illinois Pc |
|---|---|
| Speciality | Social Worker |
| Location | 6392 Linden Rd, Rockford, Illinois |
| Authorized Official Name and Position | Stacy Cloyd (SECRETARY) |
| Authorized Official Contact | 7633304953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optum Behavioral Care Therapy Services Of Illinois Pc 6392 Linden Rd Rockford IL 61109-2816 Ph: (779) 368-0060 | Optum Behavioral Care Therapy Services Of Illinois Pc 6392 Linden Rd Rockford IL 61109-2816 Ph: (779) 368-0060 |
| NPI Number | 1235949553 |
|---|---|
| Provider Enumeration Date | 01/09/2025 |
| Last Update Date | 03/07/2025 |
| Certification Date | 03/07/2025 |
| Medicare PECOS PAC ID | 2163944190 |
|---|---|
| Medicare Enrollment ID | O20250319003644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235949553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christina M Warden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225371008 PECOS PAC ID: 5890006860 Enrollment ID: I20150617000781 |
| Provider Name | Juliet Walden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154614634 PECOS PAC ID: 5799098463 Enrollment ID: I20150723009366 |
| Provider Name | David E Braun |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316327836 PECOS PAC ID: 4183930720 Enrollment ID: I20150827002644 |
| Provider Name | Anissa Dean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497261762 PECOS PAC ID: 1052671021 Enrollment ID: I20180213000422 |
| Provider Name | Denise Colette Beaufait |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568924157 PECOS PAC ID: 9638411036 Enrollment ID: I20190506001455 |
| Provider Name | Philip L Curtin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265497754 PECOS PAC ID: 5991734089 Enrollment ID: I20191003003622 |
| Provider Name | Mary Wilkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700585064 PECOS PAC ID: 4587021514 Enrollment ID: I20230607001733 |
| Provider Name | Renae Rose Wood |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1710346689 PECOS PAC ID: 0648623561 Enrollment ID: I20240126003574 |
| Provider Name | Linda Kayser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790477172 PECOS PAC ID: 2365885738 Enrollment ID: I20240213002689 |
| Provider Name | Karen Lauer |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982883633 PECOS PAC ID: 6103265632 Enrollment ID: I20240417001873 |
| Provider Name | Amy Bruyn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366930406 PECOS PAC ID: 2769925312 Enrollment ID: I20240624003383 |
| Provider Name | Gail Logemann |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1083802540 PECOS PAC ID: 2860935327 Enrollment ID: I20240625002014 |
| Provider Name | Ashley Sabbath Dehn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669020905 PECOS PAC ID: 5092259689 Enrollment ID: I20240708001777 |
| Provider Name | Dennis Delfosse |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164512182 PECOS PAC ID: 9234676065 Enrollment ID: I20240730000899 |
| Provider Name | Brian Fagan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669013843 PECOS PAC ID: 6608313473 Enrollment ID: I20240730002306 |
| Provider Name | Michael Purszke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134492796 PECOS PAC ID: 9537606306 Enrollment ID: I20240730002637 |
| Provider Name | Amanda Rezin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396415121 PECOS PAC ID: 3971040551 Enrollment ID: I20240731002906 |
| Provider Name | Charlotte Reed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619567385 PECOS PAC ID: 9830636414 Enrollment ID: I20240731003093 |
| Provider Name | Christina Cerk |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063785947 PECOS PAC ID: 4880131358 Enrollment ID: I20240801001893 |
| Provider Name | Koren Ayres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679074629 PECOS PAC ID: 5193262442 Enrollment ID: I20240805000316 |
| Provider Name | Katherine Mcbroome |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700240777 PECOS PAC ID: 8022540327 Enrollment ID: I20241011000309 |
| Provider Name | Samantha Karrel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962946541 PECOS PAC ID: 5698105492 Enrollment ID: I20241014003945 |
| Provider Name | Noelle Dominique Darnold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689189995 PECOS PAC ID: 1557894706 Enrollment ID: I20241028001382 |
| Provider Name | Barbara Noonan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144387002 PECOS PAC ID: 3678007184 Enrollment ID: I20241106002619 |
| Provider Name | Mary Earle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689442519 PECOS PAC ID: 7618407974 Enrollment ID: I20250217000659 |
| Provider Name | Adam Figlewicz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750818563 PECOS PAC ID: 5597295865 Enrollment ID: I20250217000781 |
| Provider Name | Vernalynne De La Rosa |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982917498 PECOS PAC ID: 2769908433 Enrollment ID: I20250424003627 |
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