| Tracy Lynn Sashidharan, LCPC | |
|
9 Junction Dr W Ste 3, Glen Carbon, IL 62034-2931 | |
| (618) 710-4123 | |
| (618) 731-4082 |
| Full Name | Tracy Lynn Sashidharan |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 9 Junction Dr W Ste 3, Glen Carbon, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013245737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | 018.0007365 (Illinois) | Primary |
| Entity Name | Southern Il Institute Of Behavioral Health Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346562881 PECOS PAC ID: 8527190206 Enrollment ID: O20100715000368 |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy Lynn Sashidharan, LCPC Po Box 98, Edwardsville, IL 62025-0098 Ph: (618) 710-4123 | Tracy Lynn Sashidharan, LCPC 9 Junction Dr W Ste 3, Glen Carbon, IL 62034-2931 Ph: (618) 710-4123 |
Davide Pace, Counselor Medicare: Not Enrolled in Medicare Practice Location: 88 S Main St, Glen Carbon, IL 62034 Phone: 618-288-8085 Fax: 618-288-8959 | |
Emily Fedrigon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 88 S Main St, Glen Carbon, IL 62034 Phone: 618-288-8085 Fax: 618-288-8959 | |
Wendy Ann Schwarz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 88 S Main St, Glen Carbon, IL 62034 Phone: 618-288-8085 Fax: 618-288-8959 | |
Dr. Brian Glen Storey, D.MIN. Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 Junction Dr, Ste. B, Glen Carbon, IL 62034 Phone: 618-659-1606 Fax: 314-835-1016 | |
Christina Stevens, Counselor Medicare: Not Enrolled in Medicare Practice Location: 88 S Main St Ste 2, Glen Carbon, IL 62034 Phone: 618-288-8085 Fax: 618-288-8959 | |
Sherry Mccrady, Counselor Medicare: Not Enrolled in Medicare Practice Location: 88 S Main St Ste 2, Glen Carbon, IL 62034 Phone: 618-288-8085 Fax: 618-288-8959 |