| The Robert Young Center For Community Mental Health | |
|
2701 17th St Rock Island IL 61201-5351 | |
| (309) 779-3000 | |
| (309) 779-2078 |
| Full Name | The Robert Young Center For Community Mental Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 2701 17th St, Rock Island, Illinois |
| Authorized Official Name and Position | Dennis Duke (PRESIDENT) |
| Authorized Official Contact | 3097792043 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Robert Young Center For Community Mental Health 4600 3rd St Moline IL 61265-6106 Ph: (309) 779-2031 | The Robert Young Center For Community Mental Health 2701 17th St Rock Island IL 61201-5351 Ph: (309) 779-3000 |
| NPI Number | 1710276399 |
|---|---|
| Provider Enumeration Date | 04/04/2011 |
| Last Update Date | 11/17/2021 |
| Certification Date | 11/17/2021 |
| Medicare PECOS PAC ID | 4587600150 |
|---|---|
| Medicare Enrollment ID | O20220303002245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710276399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Roxanne M Nash |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235122060 PECOS PAC ID: 3577545565 Enrollment ID: I20040603000534 |
| Provider Name | Carla J Mohr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891788618 PECOS PAC ID: 0042292039 Enrollment ID: I20040603000596 |
| Provider Name | James Anthony M Sales |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902885569 PECOS PAC ID: 2860468022 Enrollment ID: I20040908001476 |
| Provider Name | James J Pugliano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346251030 PECOS PAC ID: 2466532783 Enrollment ID: I20071227000488 |
| Provider Name | Gonchigari Narayana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124016902 PECOS PAC ID: 3678577350 Enrollment ID: I20090109000479 |
| Provider Name | Julie E Zude |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699821546 PECOS PAC ID: 0244385359 Enrollment ID: I20090825000652 |
| Provider Name | John C Ciaccio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932168457 PECOS PAC ID: 8426040924 Enrollment ID: I20101007000223 |
| Provider Name | Bobby J Leebold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164728127 PECOS PAC ID: 3476721119 Enrollment ID: I20110722000518 |
| Provider Name | Susan Klingaman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821207986 PECOS PAC ID: 7315109535 Enrollment ID: I20120504000578 |
| Provider Name | Sheikh Latif |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306052345 PECOS PAC ID: 4082771456 Enrollment ID: I20130410000128 |
| Provider Name | Kurtis M Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134465263 PECOS PAC ID: 3173761954 Enrollment ID: I20130606000528 |
| Provider Name | Julie Lynn Voelker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083876395 PECOS PAC ID: 2466689401 Enrollment ID: I20131218001018 |
| Provider Name | Treena M Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114394491 PECOS PAC ID: 8426365156 Enrollment ID: I20150914001378 |
| Provider Name | Katherine A Zerull |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639426455 PECOS PAC ID: 0042509481 Enrollment ID: I20160622001855 |
| Provider Name | Sydnee Jean Hogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548779291 PECOS PAC ID: 7517223258 Enrollment ID: I20171204000556 |
| Provider Name | William P Liebbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841744646 PECOS PAC ID: 8325308794 Enrollment ID: I20180214000004 |
| Provider Name | Christine L Gradert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700998176 PECOS PAC ID: 0042570400 Enrollment ID: I20180215000012 |
| Provider Name | Heather L Hogbin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205386356 PECOS PAC ID: 9234494782 Enrollment ID: I20180621001295 |
| Provider Name | Mi Y Nelson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407274293 PECOS PAC ID: 4981994852 Enrollment ID: I20181211001452 |
| Provider Name | Birju Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699018317 PECOS PAC ID: 1557608338 Enrollment ID: I20190218001452 |
| Provider Name | Ahmed Z Elmaadawi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114189305 PECOS PAC ID: 3678744240 Enrollment ID: I20190510001251 |
| Provider Name | Dara Ann Wilczynski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891180154 PECOS PAC ID: 0446551667 Enrollment ID: I20190816001998 |
| Provider Name | Gloria Guillen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659901106 PECOS PAC ID: 8729418850 Enrollment ID: I20200413004027 |
| Provider Name | Doyle P Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780292425 PECOS PAC ID: 3971921222 Enrollment ID: I20201019002020 |
| Provider Name | Penny Ann Liebbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205436052 PECOS PAC ID: 9335553155 Enrollment ID: I20210205001024 |
| Provider Name | Michelle Shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114571445 PECOS PAC ID: 4385073808 Enrollment ID: I20210317002505 |
| Provider Name | Kendra Renner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427529072 PECOS PAC ID: 8729497201 Enrollment ID: I20210513001156 |
| Provider Name | Stephanie Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881143527 PECOS PAC ID: 9739576778 Enrollment ID: I20220421002557 |
| Provider Name | Jamsheed H Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578850277 PECOS PAC ID: 6002133261 Enrollment ID: I20220614001555 |
| Provider Name | Kelly Bitel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740349992 PECOS PAC ID: 4688767452 Enrollment ID: I20220629002244 |
| Provider Name | Breeanna Stegall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285372375 PECOS PAC ID: 3476923277 Enrollment ID: I20230111001881 |
| Provider Name | Marcey Kay Millage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316677339 PECOS PAC ID: 3072983030 Enrollment ID: I20230324001026 |
| Provider Name | Gretchen Yungen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801509898 PECOS PAC ID: 6507225000 Enrollment ID: I20230630001687 |
| Provider Name | Amanda Pease |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124799481 PECOS PAC ID: 5294194635 Enrollment ID: I20230703003191 |
| Provider Name | Josie Bahen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265988851 PECOS PAC ID: 1557711744 Enrollment ID: I20240101000011 |
| Provider Name | Lucy A Manis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902928484 PECOS PAC ID: 4082063235 Enrollment ID: I20240108003273 |
| Provider Name | Christine Sarah Keemle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639638885 PECOS PAC ID: 0244681864 Enrollment ID: I20240109000557 |
| Provider Name | Tara A Furgason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609105899 PECOS PAC ID: 9537518949 Enrollment ID: I20240110002981 |
| Provider Name | Alyx Milani Dereu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982149217 PECOS PAC ID: 0446601660 Enrollment ID: I20240111002444 |
| Provider Name | Stephen Mark Draminski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124146907 PECOS PAC ID: 0547618316 Enrollment ID: I20240115000559 |
| Provider Name | Paula Jaeger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790271575 PECOS PAC ID: 1850743766 Enrollment ID: I20240116004273 |
| Provider Name | Daniel Craig Scritchfield |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760896724 PECOS PAC ID: 9739539412 Enrollment ID: I20240205000546 |
| Provider Name | Eryka Berglund |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356896278 PECOS PAC ID: 1759823933 Enrollment ID: I20240603003136 |
| Provider Name | Rayna Narvaez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740042373 PECOS PAC ID: 4789021601 Enrollment ID: I20240612002177 |
| Provider Name | Steffanie Lynn Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871148999 PECOS PAC ID: 2769919471 Enrollment ID: I20241219001187 |
| Provider Name | Paul Andrew Fecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215715982 PECOS PAC ID: 6608303813 Enrollment ID: I20250318002404 |
| Provider Name | Emily Anne Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609439009 PECOS PAC ID: 9931628419 Enrollment ID: I20250528001937 |
Dwyer-elias Counseling And Therapy, P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1800 3rd Ave, Suite 516, Rock Island, IL 61201 Phone: 309-788-1050 | |
Trinity Medical Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2701 17th St, Rock Island, IL 61201 Phone: 309-779-3000 | |
Catholic Charities Dop Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4703 44th St, Rock Island, IL 61201 Phone: 309-788-9581 Fax: 309-788-9581 | |
The Robert Young Center For Community Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 3rd Ave, Rock Island, IL 61201 Phone: 309-779-2094 Fax: 309-779-2027 | |
Transitions Nfp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 19th St, Rock Island, IL 61201 Phone: 309-793-4993 Fax: 309-793-9053 | |
The Robert Young Center For Community Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2701 17th St, Rock Island, IL 61201 Phone: 309-779-3001 Fax: 309-779-5222 | |
James A M Sales Md Sc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2508 25th St, Rock Island, IL 61201 Phone: 309-786-0600 Fax: 309-786-8352 |