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Organization
MOSAIC COUNSELING SERVICES, INC
Active
Organization
MOSAIC COUNSELING SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE YATES LCPC (OWNER)
(815) 846-0684
Entity
Organization
Contact information
Practice address
6072 BRYNWOOD DR STE 107, ROCKFORD, IL 61114-5829
(815) 846-0684
(888) 827-2114
Mailing address
6072 BRYNWOOD DR STE 107, ROCKFORD, IL 61114-5829
(815) 846-0684
(888) 827-2114
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003319781
NPI TYPE 1
—
Enumeration date
04/20/2022
Last updated
06/15/2022
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