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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