Calmly Centered Therapy, PLLC
Organization Active NPI Clinical Social Worker · Spring Grove, IL
NPI 1558030148 · NPPES record last updated Sep 8, 2021
Key facts
- NPI
- 1558030148
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- CALMLY CENTERED THERAPY, PLLC
- Practice address
- 3809 Magnolia Dr
Spring Grove, IL 60081-8631 - Phone
- (612) 741-1178
- NPI assigned
- Sep 8, 2021
- Organization subpart
- No
Authorized official
- Name
- Mrs. Audrey Elizabeth Damore, LCSW & CADC
- Title
- Business Owner and Therapist
- Phone
- (612) 741-1178
Practitioners 3
-
Audrey Damore, L.C.S.W., C.A.D.C.
-
Jennifer Lynn Boston, MSW, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211005001213 | IL | Part B Supplier - Clinic/Group Practice | 7618375783 |
Receives reassigned benefits from 3 practitioners Practice locations: Richmond, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
3809 Magnolia Dr
Spring Grove, IL 60081-8631
Mailing address
3809 Magnolia Dr
Spring Grove, IL 60081-8631
Phone (612) 741-1178
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | calmly-centered.com |
Other providers in Spring Grove, IL
- Sheryl Baumgart
- Kelsey Bennett
- Kyle Lynn Beres
- Brian a. Rybicki, DDS, P.C.
- Natalie Caliendo Johnson
- Audrey Damore
- Lauren Destephano
- Nikolas Destephano
- Ralph Destephano
- Elizabeth J. Devaney
All providers in Spring Grove, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2021. 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.