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2101 James St Lawrenceville IL 62439-2027 | |
| (618) 943-3302 | |
| (618) 943-3657 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2101 James St, Lawrenceville, Illinois |
| Authorized Official Name and Position | Amy Marley (ADMINISTRATOR) |
| Authorized Official Contact | 6189433302 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2101 James St Lawrenceville IL 62439-2027 Ph: (618) 943-3302 | 2101 James St Lawrenceville IL 62439-2027 Ph: (618) 943-3302 |
| NPI Number | 1326454356 |
|---|---|
| Provider Enumeration Date | 07/10/2014 |
| Last Update Date | 02/08/2023 |
| Certification Date | 02/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326454356 | NPI | - | NPPES |
| 036072942 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Resilient Counseling Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1308 Collins Ave, Lawrenceville, IL 62439 Phone: 618-510-9131 Fax: 217-670-6713 | |
Maple Street Clinic Ltd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 15th St, Lawrenceville, IL 62439 Phone: 618-839-4618 Fax: 618-943-1700 | |