Provider Demographics
NPI:1336902592
Name:CENTERED THERAPY & WELLNESS PLLC
Entity Type:Organization
Organization Name:CENTERED THERAPY & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLANERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:309-320-8839
Mailing Address - Street 1:200 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:IL
Mailing Address - Zip Code:61550-1804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:IL
Practice Address - Zip Code:61550-1804
Practice Address - Country:US
Practice Address - Phone:309-320-8839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1467078436OtherINDIVIDUAL NPI GLANERT
IL1568945061OtherINDIVIDUAL NPI SCHIEFERLE UHLENBROCK