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NPI Code Detail

MEDICARE: GREAT CHANGES COUNSELING SERVICES, P.C.

MEDICARE: GREAT CHANGES COUNSELING SERVICES, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149010490IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11114030251OTHERILNPI INDIVIDUAL #

General Provider Information

NPI Number : 1205137346
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREAT CHANGES COUNSELING SERVICES, P.C.
Provider Business Mailing Address
First Line : 9435 BORMET DR STE 5
Second Line :
City : MOKENA
State : IL
Zip : 60448-7401
Country : US
Telephone Number : 815-260-2566
Fax Number :
Provider Business Practice Location Address
First Line : 9435 BORMET DR STE 5
Second Line :
City : MOKENA
State : IL
Zip : 60448-7401
Country : US
Telephone Number : 815-260-2566
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : DONNA M WELTER
Credential : LCSW
Telephone Number : 815-260-2566
Provider Enumeration Date : 11/05/2010
Last Update Date : 03/10/2026

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Directions to “GREAT CHANGES COUNSELING SERVICES, P.C. ” Practice Location

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