| Resilient Roots Therapy Pllc | |
|
3600 S Water Tower Pl Mount Vernon IL 62864-6589 | |
| (618) 244-0212 | |
| (618) 244-0535 |
| Full Name | Resilient Roots Therapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 3600 S Water Tower Pl, Mount Vernon, Illinois |
| Authorized Official Name and Position | Melanie Downen (OWNER/ MANAGER) |
| Authorized Official Contact | 6182440212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resilient Roots Therapy Pllc 3600 S Water Tower Pl Mount Vernon IL 62864-6589 Ph: (618) 244-0212 | Resilient Roots Therapy Pllc 3600 S Water Tower Pl Mount Vernon IL 62864-6589 Ph: (618) 244-0212 |
| NPI Number | 1689497794 |
|---|---|
| Provider Enumeration Date | 11/06/2024 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Medicare PECOS PAC ID | 7810418803 |
|---|---|
| Medicare Enrollment ID | O20250306001685 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689497794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Melanie Downen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679232607 PECOS PAC ID: 8729509716 Enrollment ID: I20250306001906 |
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