| Kristi Ann Weaver, | |
|
2311 S Illinois Ave, Carbondale, IL 62903-5912 | |
| (618) 457-6703 | |
| (618) 549-3734 |
| Full Name | Kristi Ann Weaver |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 17 Years |
| Location | 2311 S Illinois Ave, Carbondale, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053669903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180009792 (Illinois) | Secondary |
| 101YM0800X | Counselor - Mental Health | 180.009792 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Brave Health Medical Group, Pa | 9537586052 | 51 |
| Entity Name | Brave Health Medical Group, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225669161 PECOS PAC ID: 9537586052 Enrollment ID: O20210129001373 |
| Entity Name | Sondermind Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003646977 PECOS PAC ID: 0547795791 Enrollment ID: O20241125001063 |
| Mailing Address | Practice Location Address |
|---|---|
| Kristi Ann Weaver, 1190 Grand Oak Dr, Carbondale, IL 62901-5474 Ph: (618) 534-0607 | Kristi Ann Weaver, 2311 S Illinois Ave, Carbondale, IL 62903-5912 Ph: (618) 457-6703 |
Mr. Dave Scott Evans, MS, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 604 East College, Carbondale, IL 62901 Phone: 618-457-6703 Fax: 618-529-4563 | |
Emily Margaret Macdonald, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 629-278-2696 | |
Ms. Melissa Cauthen, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 1016 S Emerald Ln, Carbondale, IL 62901 Phone: 618-559-6346 | |
Poorva Talapatra, M.ED., LCPC Counselor Medicare: Accepting Medicare Assignments Practice Location: 400 S Lewis Ln, Carbondale, IL 62901 Phone: 618-519-9900 Fax: 618-529-1384 | |
Levi Wampler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 618-615-9754 | |
Lindsay Miller, LCPC Counselor Medicare: Accepting Medicare Assignments Practice Location: 101 S Wall St, Carbondale, IL 62901 Phone: 618-519-9200 Fax: 618-519-9404 | |
Ms. Jane Kidwell, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 35 Albany Rd, Suite E, Carbondale, IL 62903 Phone: 618-241-2128 Fax: 618-241-3848 |