Lyndsey Michelle Wideman, MA,LCPC | |
2311 S Illinois Ave, Carbondale, IL 62903-5912 | |
(618) 457-6703 | |
(618) 549-3734 |
Full Name | Lyndsey Michelle Wideman |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 2311 S Illinois Ave, 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 |
---|---|---|---|
1487287835 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 180.015448 (Illinois) | Primary |
Entity Name | Centerstone Of Illinois Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053455667 PECOS PAC ID: 2961545173 Enrollment ID: O20100209000763 |
Mailing Address | Practice Location Address |
---|---|
Lyndsey Michelle Wideman, MA,LCPC 902 W Main St, West Frankfort, IL 62896-2210 Ph: (618) 937-6483 | Lyndsey Michelle Wideman, MA,LCPC 2311 S Illinois Ave, Carbondale, IL 62903-5912 Ph: (618) 457-6703 |
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 |