| Maple Street Clinic Ltd | |
|
1401 15th St Lawrenceville IL 62439-2223 | |
| (618) 839-4618 | |
| (618) 943-1700 |
| Full Name | Maple Street Clinic Ltd |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1401 15th St, Lawrenceville, Illinois |
| Authorized Official Name and Position | Linda E Hungerford (PRESIDENT) |
| Authorized Official Contact | 6188391561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Street Clinic Ltd 1401 15th St Lawrenceville IL 62439-2223 Ph: (618) 839-4618 | Maple Street Clinic Ltd 1401 15th St Lawrenceville IL 62439-2223 Ph: (618) 839-4618 |
| NPI Number | 1245252204 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 03/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245252204 | NPI | - | NPPES |
| 036072942 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036072942 (Illinois) | Primary |
Resilient Counseling Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1308 Collins Ave, Lawrenceville, IL 62439 Phone: 618-510-9131 Fax: 217-670-6713 | |
Lawrence County Health Dept Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2101 James St, Lawrenceville, IL 62439 Phone: 618-943-3302 Fax: 618-943-3657 | |
County Of Lawrence Health Department Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2101 James St, Lawrenceville, IL 62439 Phone: 618-943-3302 Fax: 618-943-3657 | |
S E Illinois Counseling Ctrs Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Olive St, Lawrenceville, IL 62439 Phone: 618-943-3451 Fax: 618-943-4368 |