Along the Path Counseling Services P.C.
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Rockford, IL
NPI 1306070032 · NPPES record last updated May 9, 2009
Key facts
- NPI
- 1306070032
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- License
- 060010196 (IL)
- Legal business name
- ALONG THE PATH COUNSELING SERVICES P.C.
- Practice address
- 433 S Phelps Ave
Suite 2
Rockford, IL 61108-2442 - Phone
- (815) 397-4287
- Fax
- (815) 397-3136
- NPI assigned
- May 9, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Jason Andrew Peckels, LCPC
- Title
- President
- Phone
- (414) 801-7905
Practitioners 5
-
Jason Andrew Peckels, M.S.ED., L.P.C.
-
Raia Elizabeth Lipford, MSED, LCPC, NCC
-
Nicole Ping Ticknor, LPC
-
Stephanie Yates, LCPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240829001497 | IL | Part B Supplier - Clinic/Group Practice | 5395284780 |
Receives reassigned benefits from 1 practitioner Practice locations: Rockford, IL |
National Provider Directory
Locations
433 Phelps Ave
Ste 2
Rockford, IL 61108
Phone (815) 397-4287
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 060010196 | IL | Yes |
Addresses
Primary practice location
433 S Phelps Ave
Suite 2
Rockford, IL 61108-2442
Mailing address
433 S Phelps Ave
Suite 2
Rockford, IL 61108-2442
Phone (815) 397-4287
Other providers in Rockford, IL
- Susan D Allen
- Arlyn O Alley
- Allison Benthal D.O. S.C.
- Allison Bozovsky, LMFT, LLC
- Laura Lynn Allman
- Alpine Fireside Health Center LTD
- Hajir Alsamraay
- Faour Alshare
- Lina Alsibaie
- Hannah Alt
All providers in Rockford, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.