| Taryn Ellison, LCPC | |
|
319 E Madison St Ste 1f, Springfield, IL 62701-3118 | |
| (217) 545-8000 | |
| (217) 757-8161 |
| Full Name | Taryn Ellison |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 319 E Madison St Ste 1f, Springfield, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942995675 | NPI | - | NPPES |
| Entity Name | Board Of Trustees Of Southern Illinois University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396097960 PECOS PAC ID: 4486667888 Enrollment ID: O20130424001019 |
| Mailing Address | Practice Location Address |
|---|---|
| Taryn Ellison, LCPC Po Box 19639, Springfield, IL 62794-9639 Ph: (217) 545-8000 | Taryn Ellison, LCPC 319 E Madison St Ste 1f, Springfield, IL 62701-3118 Ph: (217) 545-8000 |
Mr. Jonathan Dean Ponser, M.A., LCPC, NCC Counselor Medicare: Medicare Enrolled Practice Location: 901 N 1st St, Springfield, IL 62702 Phone: 217-788-4065 Fax: 217-778-8414 | |
Michele L Herron, LCPC, CADC/MISA II Counselor Medicare: Not Enrolled in Medicare Practice Location: 408 S 5th St, Springfield, IL 62701 Phone: 217-528-1988 Fax: 217-528-1989 | |
Amy Nudo I, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 5230 South 6th Street Road, Springfield, IL 62703 Phone: 217-585-1180 Fax: 217-585-5651 | |
Barbara J. Wolfson, L.C.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1025 S 6th St, Springfield, IL 62703 Phone: 217-528-7541 | |
Jenna Yates, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3233 Mathers Rd Ste A, Springfield, IL 62711 Phone: 217-899-5412 | |
Kayla Jane Gerdes, MA, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 426 W Cook St, Springfield, IL 62704 Phone: 217-502-0678 | |
Rachel Rambach, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4481 Ash Grove Dr Ste B, Springfield, IL 62711 Phone: 217-970-2727 |