Provider Demographics
NPI:1205928942
Name:SUCCESS MOTIVATORS, LLC
Entity type:Organization
Organization Name:SUCCESS MOTIVATORS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRABE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:618-281-9355
Mailing Address - Street 1:276 SOUTHWOODS CTR
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBIA
Mailing Address - State:IL
Mailing Address - Zip Code:62236-2462
Mailing Address - Country:US
Mailing Address - Phone:618-281-9355
Mailing Address - Fax:618-281-4641
Practice Address - Street 1:276 SOUTHWOODS CTR
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBIA
Practice Address - State:IL
Practice Address - Zip Code:62236-2462
Practice Address - Country:US
Practice Address - Phone:618-281-9355
Practice Address - Fax:618-281-4641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490118461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
214227Medicare PIN