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927 Broadway St Quincy IL 62301-2719 | |
| (217) 223-8400 | |
| (217) 223-9945 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 927 Broadway St, Quincy, Illinois |
| Authorized Official Name and Position | Timothy A Moore (CAO) |
| Authorized Official Contact | 2172231200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1005 Broadway St Quincy IL 62301-2834 Ph: (217) 223-8400 | 927 Broadway St Quincy IL 62301-2719 Ph: (217) 223-8400 |
| NPI Number | 1073918462 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 11/27/2023 |
| Certification Date | 03/11/2020 |
| Medicare PECOS PAC ID | 3072422534 |
|---|---|
| Medicare Enrollment ID | O20150601000404 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073918462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 0000141 (Illinois) | Primary |
| Provider Name | Kelli Lunt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821420779 PECOS PAC ID: 5294045936 Enrollment ID: I20151109000460 |
| Provider Name | Katherine Thomure |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043727522 PECOS PAC ID: 8820358633 Enrollment ID: I20180215001490 |
| Provider Name | Mary Ruth Ripper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235357013 PECOS PAC ID: 9032578455 Enrollment ID: I20230703002169 |
Living Hope Counseling Center, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 535 Maine St, Suite 13, Quincy, IL 62301 Phone: 217-228-1887 Fax: 217-228-1884 | |
Bartlow Counseling Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 731 N 24th St Ste A, Quincy, IL 62301 Phone: 217-223-4673 Fax: 630-563-9020 | |
Preferred Family Healthcare, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 418 S 36th St, Quincy, IL 62301 Phone: 217-224-6300 Fax: 217-224-4329 | |