Beacon Of Enlightenment
Counselor in Rockford, IL. Organization (NPI-2).
NPI number1376200550
StatusActive
Last updated in NPPESApr 14, 2025
Details
- NPI
- 1376200550
- Entity type
- Organization (NPI-2)
- Legal business name
- Beacon Of Enlightenment
- Organization subpart
- No
- Enumeration date
- Nov 22, 2021
- Certification date
- Apr 14, 2025
- Last updated
- Apr 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
6072 Brynwood Dr Ste 201Rockford, IL 61114-5829
Phone 815-564-8633 · Fax 779-423-0778
Mailing address
451 Coventry Ln Ste 100Crystal Lake, IL 60014-7589
Phone 815-564-8633 · Fax 779-423-0778
Authorized official
Crisy Gowan
Owner
8155648633
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