| Sea Glass Counseling, Llc | |
|
2103 E Washington St Ste 2f Bloomington IL 61701-4365 | |
| (309) 740-1157 | |
| Not Available |
| Full Name | Sea Glass Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2103 E Washington St Ste 2f, Bloomington, Illinois |
| Authorized Official Name and Position | Darci Newton (OWNER/LICENSED THERAPIST) |
| Authorized Official Contact | 3097401157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sea Glass Counseling, Llc Po Box 171 Hudson IL 61748-0171 Ph: (309) 740-1157 | Sea Glass Counseling, Llc 2103 E Washington St Ste 2f Bloomington IL 61701-4365 Ph: (309) 740-1157 |
| NPI Number | 1740705946 |
|---|---|
| Provider Enumeration Date | 08/08/2017 |
| Last Update Date | 12/19/2023 |
| Certification Date | 12/19/2023 |
| Medicare PECOS PAC ID | 4981952157 |
|---|---|
| Medicare Enrollment ID | O20180803000947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740705946 | NPI | - | NPPES |
| Provider Name | Darci Newton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457780082 PECOS PAC ID: 7517235914 Enrollment ID: I20170607001285 |
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