NPI: 1053368605 · BLOOMINGTON, IL 61704 · Counselor · NPI assigned 05/28/2006
| Authorized Official | RUSSO, ADAM (VP OF OPERATIONS) |
| NPI Enumeration Date | 05/28/2006 |
Other providers sharing the same authorized official: RUSSO, ADAM
| Provider | City | State | Total Paid |
|---|---|---|---|
| CHANGE TALK LLC | ESSEX | CT | $488K |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 24 | $2K |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation | 24 | 24 | $2K |