Organization
VAN AMAN CENTER FOR WELLNESS, PLLC
Active
Organization
VAN AMAN CENTER FOR WELLNESS, PLLC
Active
Other names
Van Aman Center for Wellness, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLINE M VAN AMAN LCPC (COUNSELOR BUSINESS OWNER)
(847) 644-3672
Entity
Organization
Contact information
Practice address
1224 TOWANDA AVE STE 22, BLOOMINGTON, IL 61701-7414
(847) 644-3672
Mailing address
1413 MOSS CREEK RD, BLOOMINGTON, IL 61704-2915
(847) 644-3672
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073066155
NPI TYPE 1
IL
Enumeration date
03/15/2022
Last updated
03/15/2022
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