Mr Cory William Baxter, LCPC | |
1150 Route 54 West, Clinton, IL 61727 | |
(217) 935-9496 | |
(217) 935-4508 |
Full Name | Mr Cory William Baxter |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 1150 Route 54 West, Clinton, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740327881 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 18005753 (Illinois) | Secondary |
101YM0800X | Counselor - Mental Health | 180005753 (Illinois) | Primary |
Entity Name | Heritage Behavioral Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639231731 PECOS PAC ID: 0547208951 Enrollment ID: O20050418000456 |
Mailing Address | Practice Location Address |
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Mr Cory William Baxter, LCPC Po Box 616, Clinton, IL 61727-0616 Ph: (217) 935-9496 | Mr Cory William Baxter, LCPC 1150 Route 54 West, Clinton, IL 61727 Ph: (217) 935-9496 |
Ms. Cassandra R Laskowski, MA, LCPC, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 200 E Main St, Clinton, IL 61727 Phone: 217-412-9615 | |
Angela Louise Hilliard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 200 E Main St, Lifeway Behavioral Health Services Inc, Clinton, IL 61727 Phone: 217-935-3900 | |
Dawn Marie Schierl, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 E South St, Clinton, IL 61727 Phone: 309-434-0906 | |
Mr. David Michael Bowman, Counselor Medicare: Medicare Enrolled Practice Location: 422 W White St, Clinton, IL 61727 Phone: 217-935-9571 | |
Ms. Rebecca Stanton, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1150 State Route 54 W, Clinton, IL 61727 Phone: 217-935-9496 Fax: 217-935-4508 | |
Mr. Gregory Kirby Ingraham, MSW, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1150 Route 54 W, Clinton, IL 61727 Phone: 217-935-9496 Fax: 217-935-4508 |