| Poorva Talapatra, MED, LCPC | |
|
400 S Lewis Ln, Carbondale, IL 62901-3547 | |
| (618) 519-9900 | |
| (618) 529-1384 |
| Full Name | Poorva Talapatra |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 25 Years |
| Location | 400 S Lewis Ln, 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 |
|---|---|---|---|
| 1013210194 | NPI | - | NPPES |
| 370966854024 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 178005097 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ahuja Bariatric And Beyond | 6901289347 | 7 |
| Entity Name | Shawnee Health Service And Development Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639295314 PECOS PAC ID: 1658285671 Enrollment ID: O20031120000454 |
| Entity Name | Ahuja Bariatric & Beyond |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053043885 PECOS PAC ID: 6901289347 Enrollment ID: O20220817001520 |
| Mailing Address | Practice Location Address |
|---|---|
| Poorva Talapatra, MED, LCPC Po Box 577, 109 California St, Carterville, IL 62918-0577 Ph: (618) 985-8221 | Poorva Talapatra, MED, LCPC 400 S Lewis Ln, Carbondale, IL 62901-3547 Ph: (618) 519-9900 |
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 | |
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 |