Organization
BEACON OF ENLIGHTENMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISY GOWAN LCPC (OWNER)
(815) 564-8633
Entity
Organization
Contact information
Practice address
6072 BRYNWOOD DR STE 201, ROCKFORD, IL 61114-5829
(815) 564-8633
(779) 423-0778
Mailing address
451 COVENTRY LN STE 100, CRYSTAL LAKE, IL 60014-7589
(815) 564-8633
(779) 423-0778
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/22/2021
Last updated
04/14/2025
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