| Kelly Hull, LCPC | |
|
117 S 6th Ave, Clc Office, Maywood, IL 60153-1305 | |
| (708) 344-5536 | |
| (708) 344-5535 |
| Full Name | Kelly Hull |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 117 S 6th Ave, Maywood, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992155352 | NPI | - | NPPES |
| 1225285596 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180011054 (Illinois) | Primary |
| 101YP2500X | Counselor - Professional | 178009412 (Illinois) | Secondary |
| Entity Name | Presence Behavioral Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477622298 PECOS PAC ID: 7517864143 Enrollment ID: O20031212000734 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Hull, LCPC 1118 N Harlem Ave Apt D, River Forest, IL 60305-1559 Ph: (312) 399-7065 | Kelly Hull, LCPC 117 S 6th Ave, Clc Office, Maywood, IL 60153-1305 Ph: (708) 344-5536 |
Dr. Kate Louise Goldhaber, PHD Counselor Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
Mr. Tyler J Pullen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 117 S 6th Ave, Maywood, IL 60153 Phone: 708-681-4357 | |
Claudia Villar, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
Kathryn Harris, Counselor Medicare: Accepting Medicare Assignments Practice Location: 117 S 6th Ave, Maywood, IL 60153 Phone: 708-344-5536 | |
Ms. Pyol Thompson, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 610 N 4th Ave, Maywood, IL 60153 Phone: 708-856-6236 | |
Mr. Antony D Greenhow, MS, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 411 Madison St, Maywood, IL 60153 Phone: 708-450-3500 | |
Joseph Anthony Trotto, CADC, CRSS Counselor Medicare: Not Enrolled in Medicare Practice Location: 104 Oak St, Maywood, IL 60153 Phone: 708-345-8422 Fax: 708-344-2944 |