ASSOCIATES FOR INNOVATIVE CHANGE (NPI# 1205358579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205358579 |
| Entity Type | Organization |
| Organization Name | ASSOCIATES FOR INNOVATIVE CHANGE |
| Practice Address |
210 S 5th St Ste 103 St Charles IL 60174-2700 |
| Practice Telephone | 2246789033 |
| Mailing Telephone | 2246789033 |
| Mailing Fax Number | 2246789493 |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | DR. KATHRYN R JUZWIN (CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 2246789033 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | CLINICAL PSYCHOLOGIST | 1518158948 | 01 |
| Street Address |
210 S 5TH ST STE 103 |
| City | ST CHARLES |
| State | IL |
| Zip Code | 60174-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306474192 | Halinas Residential Home Care | Registered Nurse | 825 North Fifth Avenue, St. Charles, IL 60174 | 2020-03-29 |
| 1205354503 | Connor Lavallie | Chiropractor | 240 W River Dr, St Charles, IL 60174 | 2017-09-07 |
| 1427579952 | Melanie Elizabeth Long | Counselor | 5n147 Oak Leaf Ct, St Charles, IL 60174 | 2017-07-06 |
| 1255860656 | Hannah Elizabeth Gambrel | Counselor | 12 South 7th Avenue, St. Charles, IL 60174 | 2017-06-08 |
| 1275981490 | Anju Patel | Pharmacist | 2038 Praire St, St. Charles, IL 60174 | 2016-05-27 |
| 1316328529 | Allison Jensen | Dentist | 11 S. 2nd Ave #11, St. Charles, IL 60174 | 2015-06-12 |
| 1225466576 | Chelsea Wright | Social Worker | 522 W Main St Unit 2d, St Charles, IL 60174 | 2013-10-24 |
| 1114261427 | Bryan R. Cichon Dds PC | Dentist | 700 S. Randall Rd., Suite #1, St. Charles, IL 60174 | 2012-11-27 |
| 1124372289 | Stacey Lynn Conner | Developmental Therapist | 910 Manley Rd, St. Charles, IL 60174 | 2012-10-28 |
| 1093070567 | St. Charles Service Corporation | Physical Therapist | 1615 W. Main Street, St. Charles, IL 60174 | 2012-07-10 |
| Find all providers in zip 60174 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265792097 | Maegan Jenkins | Psychologist | 525 Dunham Rd Ste 55, St Charles, IL 60174-1490 | 2012-05-27 |
| 1780981605 | Jesse Sekey | Psychologist | 1121 E Main St Ste 320, St Charles, IL 60174-2276 | 2011-02-14 |
| 1811042021 | Thomas Alden Blood | Psychologist | 39w870 Deer Run Dr, St Charles, IL 60175-6910 | 2007-01-25 |
| 1790846749 | Associates In Clinical Services | Psychologist | 215 S 4th Ave, St Charles, IL 60174 | 2006-12-13 |
| 1356455505 | Michael Pica | Psychologist | 3381 W Main St, Suite 1, St Charles, IL 60175-1008 | 2006-08-17 |
| 1033732003 | Alter Clinical Services LLC | Psychologist | 100 Illinois St Ste 200, St Charles, IL 60174-1867 | 2020-05-25 |
| 1801369848 | Toussaint David Whetstone | Psychologist | 1120 E Main St Ste 201, St Charles, IL 60174-2287 | 2019-01-02 |
| 1801375209 | Cognitive Behavioral Care Incorporated | Psychologist | 525 Dunham Rd Ste 55, St Charles, IL 60174-1490 | 2018-08-07 |
| 1558816371 | Olesia Shalayska | Psychologist | 4n701 School Rd Ste A, St Charles, IL 60175 | 2016-08-22 |
| 1508266313 | Natalie A Pamphile | Psychologist | 2210 Dean St, Suite I, St Charles, IL 60175-1066 | 2014-08-28 |
| Find all providers in ST CHARLES | ||||
| City | ST CHARLES |
| Zip Code | 60174 |
Please comment or provide details below to improve the information on ASSOCIATES FOR INNOVATIVE CHANGE.
| 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.