| Waterford Counseling And Psychological Services, Pc | |
|
1256 Waterford Dr Suite 140 Aurora IL 60504-4510 | |
| (630) 898-5322 | |
| (630) 898-5324 |
| Full Name | Waterford Counseling And Psychological Services, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1256 Waterford Dr, Aurora, Illinois |
| Authorized Official Name and Position | Gary L Coleman (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 6308985322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterford Counseling And Psychological Services, Pc 1256 Waterford Dr Suite 140 Aurora IL 60504-4510 Ph: (630) 898-5322 | Waterford Counseling And Psychological Services, Pc 1256 Waterford Dr Suite 140 Aurora IL 60504-4510 Ph: (630) 898-5322 |
| NPI Number | 1104250067 |
|---|---|
| Provider Enumeration Date | 08/28/2013 |
| Last Update Date | 12/15/2023 |
| Certification Date | 12/15/2023 |
| Medicare PECOS PAC ID | 7012144017 |
|---|---|
| Medicare Enrollment ID | O20131219001028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104250067 | NPI | - | NPPES |
| Provider Name | Gary L Coleman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407994049 PECOS PAC ID: 2860584349 Enrollment ID: I20070829000103 |
| Provider Name | Maria Santiago |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831325497 PECOS PAC ID: 6901086537 Enrollment ID: I20110214000621 |
| Provider Name | Jenie N Umana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497098313 PECOS PAC ID: 2769620905 Enrollment ID: I20130530000386 |
| Provider Name | Sarah G Ridenour |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457562308 PECOS PAC ID: 6002030053 Enrollment ID: I20140612001094 |
| Provider Name | Elizabeth Kingsbury-puscas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942852777 PECOS PAC ID: 2668839820 Enrollment ID: I20230601002978 |
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