Louis G Sisto, | |
607 Buchanan St, Carthage, IL 62321-1401 | |
(217) 773-3325 | |
(217) 773-2425 |
Full Name | Louis G Sisto |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 607 Buchanan St, Carthage, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578873527 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Fundamental Behavioral Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699158600 PECOS PAC ID: 0345657979 Enrollment ID: O20210329000558 |
Mailing Address | Practice Location Address |
---|---|
Louis G Sisto, 700 Se Cross St, Mount Sterling, IL 62353-1561 Ph: (217) 773-3325 | Louis G Sisto, 607 Buchanan St, Carthage, IL 62321-1401 Ph: (217) 773-3325 |
Joe N Little, Counselor Medicare: Not Enrolled in Medicare Practice Location: 607 Buchanan Street, Mental Health Centers Of Western Illinois, Carthage, IL 62321 Phone: 217-357-3176 Fax: 217-357-6609 | |
Joshua Louring Fink, Counselor Medicare: Not Enrolled in Medicare Practice Location: 607 Buchanan Street, Carthage, IL 62321 Phone: 217-357-3176 Fax: 217-357-6609 | |
Lindsay Brummell, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1450 N County Road 2050 E, Carthage, IL 62321 Phone: 217-357-6888 Fax: 217-214-5450 | |
Nikolous Kuster, Counselor Medicare: Not Enrolled in Medicare Practice Location: 607 Buchanan St, Carthage, IL 62321 Phone: 217-357-3176 Fax: 217-357-6609 | |
Kristy Dykema, Counselor Medicare: Not Enrolled in Medicare Practice Location: 607 Buchanan St, Carthage, IL 62321 Phone: 217-357-3176 | |
Tiffany Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 607 Buchanan St, Mental Health Centers Of Western Illinois, Carthage, IL 62321 Phone: 217-357-3176 Fax: 217-357-6609 |