Kimberley Michelle Malloy, LCPC | |
988 N Illinois Route 3, Waterloo, IL 62298-1000 | |
(618) 939-4444 | |
(618) 939-4181 |
Full Name | Kimberley Michelle Malloy |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 988 N Illinois Route 3, Waterloo, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437588159 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 180008895 (Illinois) | Primary |
Entity Name | Comprehensive Behavioral Health Center Of St. Clair County, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720094345 PECOS PAC ID: 7810072899 Enrollment ID: O20080314000542 |
Entity Name | Southern Il Institute Of Behavioral Health Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346562881 PECOS PAC ID: 8527190206 Enrollment ID: O20100715000368 |
Mailing Address | Practice Location Address |
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Kimberley Michelle Malloy, LCPC 988 N Illinois Route 3, Po Box 146, Waterloo, IL 62298-1000 Ph: (618) 939-4444 | Kimberley Michelle Malloy, LCPC 988 N Illinois Route 3, Waterloo, IL 62298-1000 Ph: (618) 939-4444 |
John Franklin Murray, QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 988 N Illinois Route 3, Waterloo, IL 62298 Phone: 618-939-4444 Fax: 618-939-4181 | |
Darryn Haudrich, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 988 N Illinois Route 3, Waterloo, IL 62298 Phone: 618-939-4444 Fax: 618-939-4181 | |
Sabrina Gummersheimer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 988 N Illinois Route 3, Waterloo, IL 62298 Phone: 618-939-4444 | |
Julia Mary Olszewski, COUNSELOR, QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 988 N Illinois Route 3, Waterloo, IL 62298 Phone: 618-939-4444 Fax: 618-939-4181 | |
Christopher Gene Loving, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 988 N Illinois Route 3, Waterloo, IL 62298 Phone: 618-939-4444 Fax: 618-939-4181 | |
Anna Witges, LPC Counselor Medicare: Medicare Enrolled Practice Location: 988 Il-3, Waterloo, IL 62298 Phone: 618-939-4444 | |
William Kuhnert, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 988 N Illinois Route 3, Waterloo, IL 62298 Phone: 618-939-4444 |