Tara Lynn Hartley, LCSW | |
1400 Pin Oak Dr, Carterville, IL 62918-1600 | |
(618) 985-3333 | |
(618) 985-1307 |
Full Name | Tara Lynn Hartley |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 1400 Pin Oak Dr, Carterville, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639718612 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 149.021785 (Illinois) | Primary |
Entity Name | Southern Illinois Medical Services Nfp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
Mailing Address | Practice Location Address |
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Tara Lynn Hartley, LCSW Po Box 3988, Carbondale, IL 62902-3988 Ph: (618) 457-5200 | Tara Lynn Hartley, LCSW 1400 Pin Oak Dr, Carterville, IL 62918-1600 Ph: (618) 985-3333 |
Teresa Annette Eblin, LSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 403 Municipal Dr, Carterville, IL 62918 Phone: 855-608-3560 Fax: 618-956-9349 | |
Preston Simpson, MSW,LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 403 Municipal Dr, Carterville, IL 62918 Phone: 855-608-3560 Fax: 618-956-9349 | |
Mrs. Susan Elain Frease, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 211 W Grand Ave, Carterville, IL 62918 Phone: 618-559-7372 | |
Trisha Fuller, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 403 Municipal Dr, Carterville, IL 62918 Phone: 855-608-3560 Fax: 618-956-9349 | |
Debora Rich, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 505 Canary Ln, Carterville, IL 62918 Phone: 618-499-0651 | |
Ryan Rogulich, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 6355 Brandhorst Rd, Carterville, IL 62918 Phone: 618-519-9200 | |
Connie E Deen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1006 S Division St, Carterville, IL 62918 Phone: 618-985-4841 Fax: 618-985-8101 |