LOGAN HEALTH & HEALING CENTER, INC (NPI# 1184090847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184090847 |
| Entity Type | Organization |
| Organization Name | LOGAN HEALTH & HEALING CENTER, INC |
| Practice Address |
5844 Elaine Dr Suite B Rockford IL 61108-2494 |
| Practice Telephone | 8153162621 |
| Practice Fax Number | 8153162620 |
| Mailing Telephone | 8153162621 |
| Mailing Fax Number | 8153162620 |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2020-07-30 |
| Authorized Official Name | JULIE ANN LOGAN (LCSW/OWNER) |
| Authorized Official Telephone | 8153162621 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LOGAN HEALTH AND HEALING CENTER INC | 1184090847 | 01 |
| Street Address |
5844 ELAINE DR SUITE B |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-2494 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| Find all providers in zip 61108 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444070 | Susan Glover | Social Worker | 65 S Main St Lowr Level, Rockford, MI 49341-1286 | 2020-10-14 |
| 1669085445 | Lorri Ann Romesberg | Social Worker | 5738 Dorado Ct Ne, Rockford, MI 49341-8335 | 2020-08-31 |
| 1063020246 | Samantha Lane | Social Worker | 5402 Applewood Close, Rockford, IL 61114-5490 | 2020-07-14 |
| 1518587872 | Laura Kathleen Lindell | Social Worker | 4003 Mila Ave, Rockford, IL 61101-5069 | 2020-04-16 |
| 1548895527 | Stephanie Syverson | Social Worker | 695 N Perryville Rd Ste 4, Rockford, IL 61107-6225 | 2020-03-10 |
| 1508497975 | Laurie Hadler | Social Worker | 740 Tulip Ln, Rockford, IL 61107-5828 | 2020-02-03 |
| 1538708243 | Nicole Elizabeth Rundall-royal | Social Worker | 1302 Thoren Ln, Rockford, IL 61107-2662 | 2019-12-27 |
| 1568006096 | Bridget Denise Mcknight | Social Worker | 5959 Forest Trail Dr, Rockford, IL 61109-6535 | 2019-10-28 |
| 1538716105 | Geiselhart Solution Focused Therapy, LLC | Social Worker | 4102 Will Ann Dr, Rockford, IL 61101-6047 | 2019-08-20 |
| 1548816184 | Amy Hultman | Social Worker | 4320 Spring Creek Rd Ste 9, Rockford, IL 61107-1157 | 2019-08-09 |
| Find all providers in ROCKFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.