Jason E Walls, LMHC | |
727 W 2nd St, Bloomington, IN 47403-2209 | |
(812) 353-3450 | |
(812) 353-3451 |
Full Name | Jason E Walls |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 727 W 2nd St, Bloomington, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306278015 | NPI | - | NPPES |
300081403 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | 39004636A (Indiana) | Primary |
Entity Name | Indiana University Health Southern Indiana Physicians Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013953983 PECOS PAC ID: 6204748197 Enrollment ID: O20040423000556 |
Mailing Address | Practice Location Address |
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Jason E Walls, LMHC 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Jason E Walls, LMHC 727 W 2nd St, Bloomington, IN 47403-2209 Ph: (812) 353-3450 |
Ms. Delyn Kazdan, MSED Counselor Medicare: Not Enrolled in Medicare Practice Location: 1117 N Jackson St, Bloomington, IN 47404 Phone: 812-727-4181 | |
Mrs. Molly Schoberg, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1117 N Jackson St, Bloomington, IN 47404 Phone: 812-606-0264 | |
Ms. Sandra Clark, NCC, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 205 N College Avenue, Suite 210a, Bloomington, IN 47404 Phone: 812-334-1324 | |
Mr. Theodore Philip Miles, CADAC II Counselor Medicare: Not Enrolled in Medicare Practice Location: 1355 W Bloomfield Rd, Bloomington, IN 47403 Phone: 812-558-0574 | |
Ana Maria Mclamb, MA, ATR, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3100 E John Hinkle Pl, Bloomington, IN 47408 Phone: 812-323-6001 | |
Phillip Charles Librizzi, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 645 South Rogers Street, Bloomington, IN 47403 Phone: 812-339-1691 Fax: 812-339-8109 | |
Debra Hoesman, Counselor Medicare: Medicare Enrolled Practice Location: 645 S Rogers St, Bloomington, IN 47403 Phone: 812-339-1691 Fax: 812-339-8109 |