Great Lakes Neuropsychology & Counseling Llc - Mental Health Clinic in Rockford, IL

Great Lakes Neuropsychology & Counseling Llc is a mental health clinic (Psychologist - Clinical) in Rockford, Illinois. The current practice location for Great Lakes Neuropsychology & Counseling Llc is 5758 Elaine Dr, Rockford, Illinois. For appointments, you can reach them via phone at (815) 231-1280. The mailing address for Great Lakes Neuropsychology & Counseling Llc is 5758 Elaine Dr, Rockford, Illinois and phone number is (815) 231-1280.

Great Lakes Neuropsychology & Counseling Llc is licensed to practice in Illinois (license number ) and its NPI number is 1013030725. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (815) 231-1280.

Contact Information

Great Lakes Neuropsychology & Counseling Llc
5758 Elaine Dr
Rockford
IL 61108-3102
(815) 231-1280
(815) 231-1282

Mental Health Clinic Profile

Full NameGreat Lakes Neuropsychology & Counseling Llc
SpecialityPsychologist - Clinical
Location5758 Elaine Dr, Rockford, Illinois
Authorized Official Name and PositionShaun A Bong (LICENSED CLINICAL PSYCHOLOGIST/MEMB)
Authorized Official Contact8152311280
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Great Lakes Neuropsychology & Counseling Llc
5758 Elaine Dr
Rockford
IL 61108-3102

Ph: (815) 231-1280
Great Lakes Neuropsychology & Counseling Llc
5758 Elaine Dr
Rockford
IL 61108-3102

Ph: (815) 231-1280

NPI Details:

NPI Number1013030725
Provider Enumeration Date04/09/2007
Last Update Date02/05/2008

Medical Identifiers

Medical identifiers for Great Lakes Neuropsychology & Counseling Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1013030725NPI-NPPES
215368OtherILMEDICARE PTAN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103G00000XClinical Neuropsychologist (Illinois)Secondary
103G00000XClinical Neuropsychologist (Illinois)Secondary
103TC0700XPsychologist - Clinical (Illinois)Primary
103TC0700XPsychologist - Clinical (Illinois)Secondary

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› Verified 6 days ago

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