| Shawnee Health Social Services | |
|
6355 Brandhorst Rd Carterville IL 62918-3322 | |
| (618) 519-9200 | |
| (618) 985-9096 |
| Full Name | Shawnee Health Social Services |
|---|---|
| Speciality | Social Worker |
| Location | 6355 Brandhorst Rd, Carterville, Illinois |
| Authorized Official Name and Position | Christina Carney (CEO) |
| Authorized Official Contact | 6189569521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawnee Health Social Services Po Box 577 Carterville IL 62918-0577 Ph: (618) 985-8221 | Shawnee Health Social Services 6355 Brandhorst Rd Carterville IL 62918-3322 Ph: (618) 519-9200 |
| NPI Number | 1053002907 |
|---|---|
| Provider Enumeration Date | 05/19/2023 |
| Last Update Date | 04/05/2024 |
| Certification Date | 04/05/2024 |
| Medicare PECOS PAC ID | 1658285671 |
|---|---|
| Medicare Enrollment ID | O20230802000606 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053002907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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