Ms Ebony Waller, LMFT, RPT, PHD is a
Marriage & Family Therapist based in Cherry Valley, Illinois. Ms Ebony Waller is licensed to practice in Illinois (license number 166.001541) and her current practice location is
7572 N Cherryvale Blvd Apt 204, Cherry Valley, Illinois. She can be reached at her office (for appointments etc.) via phone at
(702) 572-8535.
NPI number for Ms Ebony Waller is 1982431094 and her current mailing address is 7572 N Cherryvale Blvd Apt 204, Cherry Valley, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1982431094.
Healthcare Provider's Profile
Full Name | Ms Ebony Waller |
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Gender | Female |
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Speciality | Marriage & Family Therapist |
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Location | 7572 N Cherryvale Blvd Apt 204, Cherry Valley, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1982431094
- Provider Enumeration Date: 09/14/2024
- Last Update Date: 09/14/2024
Medical Identifiers
Medical identifiers for Ms Ebony Waller such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1982431094 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
106H00000X | Marriage & Family Therapist | 166.001541 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Ebony Waller is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ms Ebony Waller, LMFT, RPT, PHD 7572 N Cherryvale Blvd Apt 204, Cherry Valley, IL 61016-9305 Ph: (702) 572-8535 | Ms Ebony Waller, LMFT, RPT, PHD 7572 N Cherryvale Blvd Apt 204, Cherry Valley, IL 61016-9305 Ph: (702) 572-8535 |
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