MEDICARE: TRUE STORY COUNSELING PLLC

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1891331567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE STORY COUNSELING PLLC

Provider Business Mailing Address
First Line	:	4509 N ILLINOIS ST STE 2
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-1524
Country	:	US
Telephone Number	:	636-358-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	4509 N ILLINOIS ST STE 5
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-1524
Country	:	US
Telephone Number	:	636-358-1800
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	JENNIFER GERLACH
Credential	:
Telephone Number	:	636-358-1800

Provider Enumeration Date	:	11/18/2019
Last Update Date	:	06/17/2024

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