| Centerstone Of Illinois, Inc | |
|
902 W Main St West Frankfort IL 62896-2210 | |
| (618) 937-6483 | |
| (618) 937-1440 |
| Full Name | Centerstone Of Illinois, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 902 W Main St, West Frankfort, Illinois |
| Authorized Official Name and Position | Stacy Phillips (ADMINISTRATOR) |
| Authorized Official Contact | 6189376483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerstone Of Illinois, Inc 902 W Main St West Frankfort IL 62896-2210 Ph: (618) 937-6483 | Centerstone Of Illinois, Inc 902 W Main St West Frankfort IL 62896-2210 Ph: (618) 937-6483 |
| NPI Number | 1053455667 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 04/23/2021 |
| Certification Date | 04/23/2021 |
| Medicare PECOS PAC ID | 2961545173 |
|---|---|
| Medicare Enrollment ID | O20100209000763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053455667 | NPI | - | NPPES |
| 351786086001 | Medicaid | IL | |
| 359629323001 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mirza S Baig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033203013 PECOS PAC ID: 3577546845 Enrollment ID: I20040615000781 |
| Provider Name | Mary L Nash-pyott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013996826 PECOS PAC ID: 1456314707 Enrollment ID: I20041108000559 |
| Provider Name | Arif Habib |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215912977 PECOS PAC ID: 8426065939 Enrollment ID: I20060308000427 |
| Provider Name | Syed S Mumtaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902995798 PECOS PAC ID: 9638121544 Enrollment ID: I20070307000432 |
| Provider Name | Elbert C Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740243989 PECOS PAC ID: 2860585858 Enrollment ID: I20070907000105 |
| Provider Name | Israr A Abbasi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518925437 PECOS PAC ID: 8325143266 Enrollment ID: I20080422000372 |
| Provider Name | John M Boget |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770585416 PECOS PAC ID: 1456548569 Enrollment ID: I20101214001229 |
| Provider Name | Tania R Mcdowell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598907727 PECOS PAC ID: 8729388293 Enrollment ID: I20151207000164 |
| Provider Name | Brittany L Mccrady |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760760433 PECOS PAC ID: 3779883194 Enrollment ID: I20151207002666 |
| Provider Name | Anupama N Wadhwa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942461231 PECOS PAC ID: 5395022511 Enrollment ID: I20170425003156 |
| Provider Name | Marguerita A Pearce |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225388739 PECOS PAC ID: 3476810755 Enrollment ID: I20171121001586 |
| Provider Name | Melissa Aaron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437505526 PECOS PAC ID: 4587901061 Enrollment ID: I20190122001639 |
| Provider Name | April L Reeder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942774922 PECOS PAC ID: 7618216821 Enrollment ID: I20190306001869 |
| Provider Name | Elaina Ward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033608112 PECOS PAC ID: 9335572619 Enrollment ID: I20191126002335 |
| Provider Name | Toni Lyn Siler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659503027 PECOS PAC ID: 9436576584 Enrollment ID: I20200903001213 |
| Provider Name | Kaitlyn R Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942840715 PECOS PAC ID: 5496161432 Enrollment ID: I20210317000699 |
| Provider Name | Preston Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083249635 PECOS PAC ID: 4587071543 Enrollment ID: I20210318002659 |
| Provider Name | Wayne O Wells |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780685743 PECOS PAC ID: 9032273073 Enrollment ID: I20210329001460 |
| Provider Name | Erica Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689179061 PECOS PAC ID: 8820405251 Enrollment ID: I20210331000231 |
| Provider Name | Britne Shamble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386282531 PECOS PAC ID: 9032528989 Enrollment ID: I20210506000953 |
| Provider Name | Brian J Reach |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1104824598 PECOS PAC ID: 6709938152 Enrollment ID: I20210920001013 |
| Provider Name | Melissa Minks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790456663 PECOS PAC ID: 9931590155 Enrollment ID: I20211223001344 |
| Provider Name | Frank Matlock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205416724 PECOS PAC ID: 7416349808 Enrollment ID: I20220114001255 |
| Provider Name | Matthew B Wilson-leigh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124659024 PECOS PAC ID: 4880089093 Enrollment ID: I20220324000762 |
| Provider Name | Jenny Vukson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205438538 PECOS PAC ID: 6103212725 Enrollment ID: I20220407002593 |
| Provider Name | Tiffany L Austin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366072886 PECOS PAC ID: 7618355751 Enrollment ID: I20220602001059 |
| Provider Name | Alyssa K Cline |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215517727 PECOS PAC ID: 3476932187 Enrollment ID: I20220625000398 |
| Provider Name | Jennifer Lynn Singleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326783200 PECOS PAC ID: 3476938200 Enrollment ID: I20220915000823 |
| Provider Name | Taylor J Holloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699376517 PECOS PAC ID: 5698142610 Enrollment ID: I20221104000304 |
| Provider Name | Anya Ryder Weber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134732860 PECOS PAC ID: 8325415896 Enrollment ID: I20221114001001 |
| Provider Name | Breauna Nicole Hurd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023729787 PECOS PAC ID: 9436529849 Enrollment ID: I20221229001797 |
| Provider Name | Jerad Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053904144 PECOS PAC ID: 4981069507 Enrollment ID: I20230503000980 |
| Provider Name | Brittany Perrotta Tillman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265079057 PECOS PAC ID: 8426423286 Enrollment ID: I20230606002906 |
| Provider Name | Madison Victoria Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851928170 PECOS PAC ID: 7810358199 Enrollment ID: I20230802003818 |
| Provider Name | Oyindamola O Aluko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275236077 PECOS PAC ID: 9638532443 Enrollment ID: I20230828000687 |
| Provider Name | Robert E Lowry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346382207 PECOS PAC ID: 0042660524 Enrollment ID: I20231226000119 |
| Provider Name | Theresa Boyd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821486044 PECOS PAC ID: 3678923158 Enrollment ID: I20231226000282 |
| Provider Name | Rachel Elaine Cochran |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104587724 PECOS PAC ID: 2668822149 Enrollment ID: I20231226000310 |
| Provider Name | Tracy Lynn Haynes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235597147 PECOS PAC ID: 6709236292 Enrollment ID: I20231226000503 |
| Provider Name | Peter N. Haller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164661716 PECOS PAC ID: 4688024177 Enrollment ID: I20231226000574 |
| Provider Name | David Hunter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609530708 PECOS PAC ID: 8123478625 Enrollment ID: I20231226000640 |
| Provider Name | Christopher Liljedahl |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710223227 PECOS PAC ID: 3577913078 Enrollment ID: I20231226000683 |
| Provider Name | Holly Sinks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538484142 PECOS PAC ID: 2365892866 Enrollment ID: I20231226000753 |
| Provider Name | Elianna Lozoya |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841973492 PECOS PAC ID: 0143670646 Enrollment ID: I20231226000870 |
| Provider Name | Evelyn Mcgee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508182858 PECOS PAC ID: 0042660540 Enrollment ID: I20231226000943 |
| Provider Name | Lyndsey Michelle Wideman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487287835 PECOS PAC ID: 5597115006 Enrollment ID: I20231226001002 |
| Provider Name | Lynda K Killoran |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780883116 PECOS PAC ID: 3274983796 Enrollment ID: I20231226001588 |
| Provider Name | Ellyn E Busker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194244178 PECOS PAC ID: 9931559465 Enrollment ID: I20231227000114 |
| Provider Name | Caleia Flannigan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790333730 PECOS PAC ID: 0749630135 Enrollment ID: I20231227002510 |
| Provider Name | Cecily Ann Heusner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154965127 PECOS PAC ID: 8123479102 Enrollment ID: I20240104001563 |
| Provider Name | Deanna Jane Heller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578011342 PECOS PAC ID: 0446601801 Enrollment ID: I20240110001315 |
| Provider Name | Blair Verfurth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285398164 PECOS PAC ID: 8325499486 Enrollment ID: I20240112002942 |
| Provider Name | Krysten Ann Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508635244 PECOS PAC ID: 4981056454 Enrollment ID: I20240119002982 |
| Provider Name | Kristin Degler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427418359 PECOS PAC ID: 3476906488 Enrollment ID: I20240125003930 |
| Provider Name | Lisa Marie Koegler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013233659 PECOS PAC ID: 2264885995 Enrollment ID: I20240130001945 |
| Provider Name | Hannah Chapman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417548983 PECOS PAC ID: 6608212311 Enrollment ID: I20240315001266 |
Centerstone Of Illinois Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 902 W Main St, West Frankfort, IL 62896 Phone: 618-937-6483 | |
Cra Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 902 W Main St, West Frankfort, IL 62896 Phone: 618-937-6483 Fax: 618-937-1440 | |
The H Group Bbt, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 902 W Main St, West Frankfort, IL 62896 Phone: 618-937-6483 Fax: 618-937-1440 | |
Spero Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 218 E Main St, West Frankfort, IL 62896 Phone: 618-242-6944 Fax: 618-242-6726 | |
Centerstone Of Illinois .org Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 902 W Main St, West Frankfort, IL 62896 Phone: 618-937-6483 Fax: 618-937-1440 | |
Centerstone Of Illinois, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 902 W Main St, West Frankfort, IL 62896 Phone: 618-937-6483 Fax: 618-937-1440 |