<unavail> in Fairfield, IL - Medicare Clinic/Center

is a medicare enrolled mental health clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Fairfield, Illinois. The current practice location for is 1007 W Main St, Fairfield, Illinois. For appointments, you can reach them via phone at (618) 842-4470. The mailing address for is Po Box 155, Christopher, Illinois and phone number is (618) 724-2401.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1902170632. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (618) 842-4470.

Contact Information


	1007 W Main St Fairfield IL 62837-2308
	(618) 842-4470
	(618) 842-3437

Map and Direction

Mental Health Clinic Profile

Full Name
Speciality	Clinic/Center
Location	1007 W Main St, Fairfield, Illinois
Authorized Official Name and Position	Kimberly A. Mitroka (CEO)
Authorized Official Contact	6187242436
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 155 Christopher IL 62822-0155 Ph: (618) 724-2401	1007 W Main St Fairfield IL 62837-2308 Ph: (618) 842-4470

NPI Details:

NPI Number	1902170632
Provider Enumeration Date	02/27/2012
Last Update Date	02/26/2024
Certification Date	02/26/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	8224947387
Medicare Enrollment ID	O20120320000084

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902170632	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	(* (Not Available))	Secondary
207Q00000X	Family Medicine	(* (Not Available))	Secondary
208000000X	Pediatrics	(* (Not Available))	Secondary
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary
363A00000X	Physician Assistant	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Virginia Leigh Mabrey
Provider Type	Practitioner - Clinical Social Worker
Provider Identifiers	NPI Number: 1306160932 PECOS PAC ID: 2769888759 Enrollment ID: I20210830002831

Reviews and Comments

Clinic/Center in Fairfield, IL

Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 N Basin Rd, Fairfield, IL 62837 Phone: 618-842-2125 Fax: 618-842-2126
Solutions Psychotherapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 W Sibley St, Fairfield, IL 62837 Phone: 618-599-3647
Mt. Vernon Counseling Center, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 114 Andrews Dr, Fairfield, IL 62837 Phone: 312-841-7674 Fax: 618-270-0524
Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 N Basin Rd, Fairfield, IL 62837 Phone: 618-273-3326 Fax: 618-273-2808
Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 N Basin Rd, Fairfield, IL 62837 Phone: 618-273-3326 Fax: 618-273-2808
Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 N Basin Rd, Fairfield, IL 62837 Phone: 618-842-2125 Fax: 618-842-4154

- Medicare Mental Health Clinic in Fairfield, IL