| Illini Community Social Workers | |
|
640 W Washington St Pittsfield IL 62363-1350 | |
| (217) 285-2113 | |
| (217) 285-2989 |
| Full Name | Illini Community Social Workers |
|---|---|
| Speciality | Social Worker |
| Location | 640 W Washington St, Pittsfield, Illinois |
| Authorized Official Name and Position | Pat Gerveler (VP-CFO) |
| Authorized Official Contact | 2172238400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illini Community Social Workers 1005 Broadway St Quincy IL 62301-2834 Ph: (217) 223-8400 | Illini Community Social Workers 640 W Washington St Pittsfield IL 62363-1350 Ph: (217) 285-2113 |
| NPI Number | 1972908390 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 11/27/2023 |
| Certification Date | 03/11/2020 |
| Medicare PECOS PAC ID | 2769420959 |
|---|---|
| Medicare Enrollment ID | O20150109001413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972908390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 0005132 (Illinois) | Primary |
| Provider Name | Melissa Kay Penn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255439105 PECOS PAC ID: 1153338009 Enrollment ID: I20060317000048 |
| Provider Name | Joy Bockhold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215163597 PECOS PAC ID: 2567629884 Enrollment ID: I20120127000950 |
| Provider Name | Jennifer Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336697010 PECOS PAC ID: 8325397938 Enrollment ID: I20180815001219 |
Mental Health Centers Of Western Illinois Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 606 W Adams St, Pittsfield, IL 62363 Phone: 217-285-4436 | |
Preferred Family Health Care, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 N Madison St, Pittsfield, IL 62363 Phone: 447-442-1921 | |
Mental Health Centers Of Western Illinois Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 S Madison St, Pittsfield, IL 62363 Phone: 217-773-3325 Fax: 217-773-2425 | |
Mental Health Centers Of Western Illinios Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1260 W Washington St, Pittsfield, IL 62363 Phone: 217-285-4436 Fax: 217-285-2804 |