| Lincoln Prairie Behavioral Health Center | |
|
5230 S 6th Street Rd Springfield IL 62703-5128 | |
| (217) 585-1180 | |
| (217) 585-4747 |
| Full Name | Lincoln Prairie Behavioral Health Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5230 S 6th Street Rd, Springfield, Illinois |
| Authorized Official Name and Position | Chrstine Statz (CFO) |
| Authorized Official Contact | 2175851180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln Prairie Behavioral Health Center 5230 S 6th Street Rd Springfield IL 62703-5128 Ph: (217) 585-1180 | Lincoln Prairie Behavioral Health Center 5230 S 6th Street Rd Springfield IL 62703-5128 Ph: (217) 585-1180 |
| NPI Number | 1407126352 |
|---|---|
| Provider Enumeration Date | 01/10/2012 |
| Last Update Date | 01/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407126352 | NPI | - | NPPES |
| 149012639 | Other | IL | LICENSED CLINICAL SOCIAL WORKER MASTERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149012639 (Illinois) | Primary |
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