| Michele L Vining, MA, PLPC | |
|
5016 N Illinois St, Suite A, Fairview Heights, IL 62208-3411 | |
| (618) 398-7250 | |
| (618) 234-6311 |
| Full Name | Michele L Vining |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 5016 N Illinois St, Fairview Heights, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417407081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180008948 (Illinois) | Primary |
| 101YP2500X | Counselor - Professional | 2016018719 (Missouri) | Secondary |
| Entity Name | St. Louis Behavioral Medicine Institute Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487732335 PECOS PAC ID: 3173428638 Enrollment ID: O20031223000497 |
| Mailing Address | Practice Location Address |
|---|---|
| Michele L Vining, MA, PLPC 7418 Foley Dr, Belleville, IL 62223-2301 Ph: (618) 972-8881 | Michele L Vining, MA, PLPC 5016 N Illinois St, Suite A, Fairview Heights, IL 62208-3411 Ph: (618) 398-7250 |
Byron Loy, LCPC, PLPC, CRADC Counselor Medicare: Medicare Enrolled Practice Location: 125 N Ruby Ln, Fairview Heights, IL 62208 Phone: 618-398-4226 Fax: 618-398-1759 | |
Nicholas Patrick Hepler, QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 8 Executive Dr Ste 200, Fairview Heights, IL 62208 Phone: 618-688-4727 | |
Tatiana Routt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8 Executive Dr, Fairview Heights, IL 62208 Phone: 618-688-4727 | |
Isabella Pfeiffer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8 Executive Dr, Fairview Heights, IL 62208 Phone: 618-688-5043 | |
Jeanette W Georgen, MA, LCPC, ATR Counselor Medicare: Not Enrolled in Medicare Practice Location: 10314 Lincoln Trl, Suite 101, Fairview Heights, IL 62208 Phone: 618-394-8952 Fax: 618-394-8952 | |
Ashley Duffie, QMHP, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 8 Executive Dr Ste 200, Fairview Heights, IL 62208 Phone: 618-688-4749 | |
Wyndi Allen-todd, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8 Executive Dr Ste 200, Fairview Heights, IL 62208 Phone: 618-688-4771 |