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Organization
STATELINE COUNSELING SERVICES LLC
Active
Organization
STATELINE COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLY LYNNE PATCHETT LCSW (OWNER)
(815) 494-9115
Entity
Organization
Contact information
Practice address
1107 N BLACKHAWK BLVD, SUITE 8, ROCKTON, IL 61072-1500
(815) 494-9115
(815) 926-5301
Mailing address
2218 CROSBY ST, ROCKFORD, IL 61107-4454
(815) 464-9115
(815) 926-5301
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.009828
IL
Other
Enumeration date
07/26/2013
Last updated
07/26/2013
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