Organization
INNER EQUINOX COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANN KRC GERLACH LCSW (CLINICAL THERAPIST)
(224) 338-6038
Entity
Organization
Contact information
Practice address
8600 US HIGHWAY 14 STE 220A, CRYSTAL LAKE, IL 60012-2711
(224) 338-6038
Mailing address
215 FENIMORE RD, CRYSTAL LAKE, IL 60014-7377
(224) 338-6038
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F400646798
—
IL
Enumeration date
04/27/2021
Last updated
12/13/2024
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