Mr Jonathan Dean Ponser, MA, LCPC, NCC | |
901 N 1st St, Springfield, IL 62702-3759 | |
(217) 788-4065 | |
(217) 778-8414 |
Full Name | Mr Jonathan Dean Ponser |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 901 N 1st St, Springfield, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003045337 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 180007267 (Illinois) | Primary |
Entity Name | Mental Health Centers Of Central Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225008113 PECOS PAC ID: 8325940521 Enrollment ID: O20040127000030 |
Entity Name | Mental Health Centers Of Central Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225008113 PECOS PAC ID: 8325940521 Enrollment ID: O20041222000489 |
Mailing Address | Practice Location Address |
---|---|
Mr Jonathan Dean Ponser, MA, LCPC, NCC 710 N 8th St, Springfield, IL 62702-6324 Ph: (217) 525-1064 | Mr Jonathan Dean Ponser, MA, LCPC, NCC 901 N 1st St, Springfield, IL 62702-3759 Ph: (217) 788-4065 |
Michele L Herron, LCPC, CADC/MISA II Counselor Medicare: Not Enrolled in Medicare Practice Location: 408 S 5th St, Springfield, IL 62701 Phone: 217-528-1988 Fax: 217-528-1989 | |
Amy Nudo I, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 5230 South 6th Street Road, Springfield, IL 62703 Phone: 217-585-1180 Fax: 217-585-5651 | |
Barbara J. Wolfson, L.C.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1025 S 6th St, Springfield, IL 62703 Phone: 217-528-7541 | |
Jenna Yates, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3233 Mathers Rd Ste A, Springfield, IL 62711 Phone: 217-899-5412 | |
Kayla Jane Gerdes, MA, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 426 W Cook St, Springfield, IL 62704 Phone: 217-502-0678 | |
Rachel Rambach, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4481 Ash Grove Dr Ste B, Springfield, IL 62711 Phone: 217-970-2727 |