| The Therapy Space Pllc | |
|
503 E Vandalia St Edwardsville IL 62025-1893 | |
| (217) 273-1849 | |
| Not Available |
| Full Name | The Therapy Space Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 503 E Vandalia St, Edwardsville, Illinois |
| Authorized Official Name and Position | Jordan Boyer Walters (OWNER/THERAPIST) |
| Authorized Official Contact | 2172731849 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Therapy Space Pllc 3328 Drysdale Ct Edwardsville IL 62025-3217 Ph: (217) 273-1849 | The Therapy Space Pllc 503 E Vandalia St Edwardsville IL 62025-1893 Ph: (217) 273-1849 |
| NPI Number | 1578419685 |
|---|---|
| Provider Enumeration Date | 03/10/2026 |
| Last Update Date | 03/10/2026 |
| Certification Date | 03/10/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578419685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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