| Ms Stephane Gail Parker, LCPC | |
|
2701 17th St, Rock Island, IL 61201-5351 | |
| (309) 779-3200 | |
| (309) 779-2755 |
| Full Name | Ms Stephane Gail Parker |
|---|---|
| Gender | Female |
| Speciality | Counselor |
| Location | 2701 17th St, Rock Island, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366872640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 180.005641 (Illinois) | Primary |
| Entity Name | Southpark Psychology Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558470419 PECOS PAC ID: 8527203090 Enrollment ID: O20130404000285 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Stephane Gail Parker, LCPC 2701 17th St, Rock Island, IL 61201-5351 Ph: (309) 779-3200 | Ms Stephane Gail Parker, LCPC 2701 17th St, Rock Island, IL 61201-5351 Ph: (309) 779-3200 |
Amber Leanne Cozad, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2701 17th St, Rock Island, IL 61254 Phone: 309-779-2031 | |
Cheyenne Tyler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2200 3rd Ave, Rock Island, IL 61201 Phone: 309-779-2064 | |
Samantha Goman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2701 17th St, Rock Island, IL 61201 Phone: 309-779-2031 | |
Ibrahim K Tarawneh, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2701 17th St, Rock Island, IL 61201 Phone: 309-779-3006 | |
Rita Sterling, MCJ, CADC, CPS Counselor Medicare: Not Enrolled in Medicare Practice Location: 211 19th St, Department Of Veterans Affairs, Ste. M2, Rock Island, IL 61201 Phone: 309-786-3591 Fax: 309-786-5135 | |
Brandon Alan Kutmas, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 4709 44th St Ste 5, Rock Island, IL 61201 Phone: 309-306-1648 Fax: 309-213-9438 | |
Amber Michelle Winters, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2701 17th St, Rock Island, IL 61201 Phone: 309-779-2031 |