Edwin Joseph Thullen, LCSW | |
1938 E Lincoln Hwy Unit 219, New Lenox, IL 60451-3860 | |
(815) 320-3749 | |
(815) 320-3825 |
Full Name | Edwin Joseph Thullen |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 1938 E Lincoln Hwy Unit 219, New Lenox, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598288870 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 149.018135 (Illinois) | Primary |
Entity Name | Copper Country Community Mental Health Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881607497 PECOS PAC ID: 8426119256 Enrollment ID: O20081211000294 |
Mailing Address | Practice Location Address |
---|---|
Edwin Joseph Thullen, LCSW 3105 W 102nd St, Evergreen Park, IL 60805-3516 Ph: (312) 718-3495 | Edwin Joseph Thullen, LCSW 1938 E Lincoln Hwy Unit 219, New Lenox, IL 60451-3860 Ph: (815) 320-3749 |
Daniel L Parrish, Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 Gougar Rd, New Lenox, IL 60451 Phone: 708-845-5500 | |
Nicole Mejstrik, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1361 E Lincoln Hwy, New Lenox, IL 60451 Phone: 815-462-4273 | |
Mr. Matthew Edward Littlefield, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2081 Calistoga Dr Ste 2s, New Lenox, IL 60451 Phone: 815-418-6070 | |
Amanda Tomaszewski, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 701 Central Rd, New Lenox, IL 60451 Phone: 512-351-1414 | |
Michelle Verheyen, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Batson Ct Ste 206, New Lenox, IL 60451 Phone: 815-409-5940 Fax: 815-206-8012 | |
Kelsey Kay, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1005 W Laraway Rd Ste 230, New Lenox, IL 60451 Phone: 815-570-9303 | |
Matthew Tevere, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1938 E Lincoln Hwy Unit 219, New Lenox, IL 60451 Phone: 815-320-3749 |