| Jane Luanne Nichols, LCPC | |
|
2601 W Main St, Carbondale, IL 62901-1031 | |
| (618) 549-5361 | |
| (618) 351-4878 |
| Full Name | Jane Luanne Nichols |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 2601 W Main St, Carbondale, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235495672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180008867 (Illinois) | Secondary |
| 101YM0800X | Counselor - Mental Health | 180008867 (Illinois) | Primary |
| Entity Name | Southern Illinois Medical Services Nfp |
|---|---|
| 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 |
|---|---|
| Jane Luanne Nichols, LCPC Po Box 3988, Carbondale, IL 62902-3988 Ph: (618) 457-5200 | Jane Luanne Nichols, LCPC 2601 W Main St, Carbondale, IL 62901-1031 Ph: (618) 549-5361 |
Mr. Dave Scott Evans, MS, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 604 East College, Carbondale, IL 62901 Phone: 618-457-6703 Fax: 618-529-4563 | |
Emily Margaret Macdonald, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 629-278-2696 | |
Ms. Melissa Cauthen, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1016 S Emerald Ln, Carbondale, IL 62901 Phone: 618-559-6346 | |
Poorva Talapatra, M.ED., LCPC Counselor Medicare: Medicare Enrolled Practice Location: 400 S Lewis Ln, Carbondale, IL 62901 Phone: 618-519-9900 Fax: 618-529-1384 | |
Levi Wampler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 618-615-9754 | |
Anna Hughes, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 618-457-6703 Fax: 618-549-3734 | |
Lindsay Miller, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 101 S Wall St, Carbondale, IL 62901 Phone: 618-519-9200 Fax: 618-519-9404 |