| Angel Knoverek, LCPC | |
|
131 N 4th St, Quincy, IL 62301-2913 | |
| (217) 223-7492 | |
| (217) 223-7516 |
| Full Name | Angel Knoverek |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 131 N 4th St, Quincy, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417242157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | 180005002 (Illinois) | Primary |
| Entity Name | Mindshift Center, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194331447 PECOS PAC ID: 8325486665 Enrollment ID: O20240404003036 |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Knoverek, LCPC 1269 Place Place, Quincy, IL 62301-4219 Ph: (217) 440-6247 | Angel Knoverek, LCPC 131 N 4th St, Quincy, IL 62301-2913 Ph: (217) 223-7492 |
Stacey Samantha Soliman Juilfs, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 639 York St Rm 212, Quincy, IL 62301 Phone: 217-222-6271 | |
Mrs. Anne-claire Marie Vahle, MSED Counselor Medicare: Not Enrolled in Medicare Practice Location: 205 S 24th St, Quincy, IL 62301 Phone: 217-222-0034 Fax: 217-222-3865 | |
Janis Lynn Frageman, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 4409 Maine, Quincy, IL 62305 Phone: 217-223-0423 Fax: 217-223-0461 | |
Nicole Antoinette Shields, MS, LCPC, QMHP Counselor Medicare: Medicare Enrolled Practice Location: 1025 Maine St, Quincy, IL 62301 Phone: 217-222-6550 | |
Kathleen Jean Nelson, M.S. ED. Counselor Medicare: Medicare Enrolled Practice Location: 1025 Maine St, Quincy, IL 62301 Phone: 217-222-6550 Fax: 217-277-2253 | |
Martinette Z Douglas, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2931 Payson Hts Apt Suite, Quincy, IL 62305 Phone: 773-669-8168 | |
Matthew Dutton, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1258 Broadway St, Quincy, IL 62301 Phone: 217-223-0170 |