| Southpark Psychology Ltd | |
|
2100 52nd Ave Moline IL 61265-6366 | |
| (309) 797-2900 | |
| (309) 797-2147 |
| Full Name | Southpark Psychology Ltd |
|---|---|
| Speciality | Psychologist |
| Location | 2100 52nd Ave, Moline, Illinois |
| Authorized Official Name and Position | Carl Vincent (OWNER) |
| Authorized Official Contact | 3097972900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southpark Psychology Ltd 2100 52nd Ave Moline IL 61265-6366 Ph: (309) 797-2900 | Southpark Psychology Ltd 2100 52nd Ave Moline IL 61265-6366 Ph: (309) 797-2900 |
| NPI Number | 1558470419 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 01/26/2018 |
| Medicare PECOS PAC ID | 8527203090 |
|---|---|
| Medicare Enrollment ID | O20130404000285 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558470419 | NPI | - | NPPES |
| Provider Name | Deborah L Sommers Krause |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801954938 PECOS PAC ID: 2668369000 Enrollment ID: I20040302000036 |
| Provider Name | Gary B Ludwig |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528078987 PECOS PAC ID: 8628059524 Enrollment ID: I20040526001407 |
| Provider Name | Elizabeth K Galbraith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740458082 PECOS PAC ID: 4082780192 Enrollment ID: I20080912000494 |
| Provider Name | Lynn M Garvin-huntley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679584544 PECOS PAC ID: 5496948747 Enrollment ID: I20101020000079 |
| Provider Name | Sharon C Lash |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780695668 PECOS PAC ID: 5092908343 Enrollment ID: I20101020000116 |
| Provider Name | Frank C Woolley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477668127 PECOS PAC ID: 1759562275 Enrollment ID: I20110216000891 |
| Provider Name | Alexander N.s.w Hogg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881024875 PECOS PAC ID: 0648403840 Enrollment ID: I20151008001644 |
| Provider Name | Kate L Stamer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871992289 PECOS PAC ID: 9931329182 Enrollment ID: I20161019002389 |
| Provider Name | Everett T Asby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881966836 PECOS PAC ID: 8022394832 Enrollment ID: I20170410002446 |
| Provider Name | Anna R Schmitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306381819 PECOS PAC ID: 7618248402 Enrollment ID: I20190109003254 |
| Provider Name | Sarah E Hott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487172755 PECOS PAC ID: 8729430772 Enrollment ID: I20240116001943 |
| Provider Name | Dale A Guebert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083755433 PECOS PAC ID: 9234582776 Enrollment ID: I20240131002448 |
| Provider Name | Valerie S Olson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770832198 PECOS PAC ID: 1951753771 Enrollment ID: I20240213001874 |
| Provider Name | Cynthia M Green |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831395524 PECOS PAC ID: 4385089341 Enrollment ID: I20240229001099 |
| Provider Name | Andrew R Furgason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912918814 PECOS PAC ID: 7618328063 Enrollment ID: I20240304000172 |
| Provider Name | Andrew J Garrison |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649757725 PECOS PAC ID: 0547611410 Enrollment ID: I20240304000225 |
| Provider Name | Carl D Vincent |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922019991 PECOS PAC ID: 2163667635 Enrollment ID: I20240304001853 |
| Provider Name | Ronald Martinez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457415325 PECOS PAC ID: 0840641585 Enrollment ID: I20240305000069 |
| Provider Name | Janice E Willis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568645414 PECOS PAC ID: 7911358387 Enrollment ID: I20240305003403 |
| Provider Name | Tara Thor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447866447 PECOS PAC ID: 4486090941 Enrollment ID: I20240307001007 |
| Provider Name | Peggy J Knaack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912775537 PECOS PAC ID: 2264878206 Enrollment ID: I20240312003250 |
| Provider Name | Christopher A Gresham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598249138 PECOS PAC ID: 2860843158 Enrollment ID: I20240409001585 |
| Provider Name | Kathleen N Morse |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275012692 PECOS PAC ID: 5991144883 Enrollment ID: I20240411001309 |
| Provider Name | Melissa L Earnest |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972804334 PECOS PAC ID: 7618317595 Enrollment ID: I20240425000690 |
| Provider Name | Stephane Parker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366872640 PECOS PAC ID: 2860832466 Enrollment ID: I20240430002182 |
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Bethany For Children & Families Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1701 River Dr Ste 200, Moline, IL 61265 Phone: 309-797-7700 Fax: 309-797-2386 | |
Gretchen L. Cromer, Md Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3302 41st St, Moline, IL 61265 Phone: 309-764-3912 Fax: 309-736-1804 | |
Ephphatha Consulting Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2424 40th Ave, Suite 5, Moline, IL 61265 Phone: 309-558-9050 | |
Transitions Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2326 16th St, Moline, IL 61265 Phone: 309-793-4993 Fax: 309-743-2277 | |
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