| Larry W Knopp, MA LCPC | |
|
16342 N Il Hwy 37, Mt Vernon, IL 62864 | |
| (618) 242-1510 | |
| (618) 242-0958 |
| Full Name | Larry W Knopp |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 16342 N Il Hwy 37, Mt Vernon, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679595458 | NPI | - | NPPES |
| 0004115177 | Other | IL | BCBS |
| 295215 | Other | HEALTHLINK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (Illinois) | Primary |
| Entity Name | Jefferson County Comprehensive |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649404708 PECOS PAC ID: 1153350103 Enrollment ID: O20050810000128 |
| Mailing Address | Practice Location Address |
|---|---|
| Larry W Knopp, MA LCPC Po Box 428, Mt Vernon, IL 62864 Ph: (618) 242-1510 | Larry W Knopp, MA LCPC 16342 N Il Hwy 37, Mt Vernon, IL 62864 Ph: (618) 242-1510 |
James Kellerman, M.H.P. Counselor Medicare: Not Enrolled in Medicare Practice Location: 16342 N Il Hwy 37, Mt Vernon, IL 62864 Phone: 618-242-1510 Fax: 618-242-0958 | |
Teresa L Barnfield, MS LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 16342 N Il Hwy 37, Mt Vernon, IL 62864 Phone: 618-242-1510 Fax: 618-242-0958 | |
Monique Stuckey, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 16348 N Il Hwy 37, Mt Vernon, IL 62864 Phone: 618-242-1510 Fax: 618-242-0958 | |
Mrs. Mary J Wilson, MS LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 123 S 10th, Suite 510, Mt Vernon, IL 62864 Phone: 618-242-8139 Fax: 618-242-8141 | |
Mrs. Keli Erin Tate, MS LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: #1 Doctor Park Road, Suite H, Mt Vernon, IL 62864 Phone: 618-244-0344 Fax: 618-244-1455 | |
Janice G Cook, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 123 S 10th St, Ste 510, Mt Vernon, IL 62864 Phone: 618-242-8139 Fax: 618-242-8141 |