LOCUST STREET RESOURCE CENTER (NPI# 1598307712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598307712 |
| Entity Type | Organization |
| Organization Name | LOCUST STREET RESOURCE CENTER |
| Practice Address |
320 S Locust St Carlinville IL 62626-1648 |
| Practice Telephone | 2178543166 |
| Practice Fax Number | 2178543778 |
| Mailing Telephone | 2178543166 |
| Mailing Fax Number | 2178543778 |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2019-10-09 |
| Authorized Official Name | SALLY MAGUIRE (CREDENTIALING CLERK) |
| Authorized Official Telephone | 2178543166 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558456210 | Locust Street Resource Center | Clinic/Center | 320 South Locust Street, Carlinville, IL 62626 | 2006-10-04 |
| Street Address |
320 S LOCUST ST |
| City | CARLINVILLE |
| State | IL |
| Zip Code | 62626-1648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265485106 | Juan M Medina | Psychiatry & Neurology | 320 S Locust St, Carlinville, IL 62626-1748 | 2006-05-19 |
| 1861005910 | Kim C Allison | Registered Nurse | 320 S Locust St, Carlinville, IL 62626-1648 | 2020-08-28 |
| 1023621158 | Ryan Watts | Registered Nurse | 320 S Locust St, Carlinville, IL 62626-1648 | 2020-08-28 |
| 1699242503 | Alexander Chipman | Counselor | 320 S Locust St, Carlinville, IL 62626-1648 | 2018-10-29 |
| 1871068817 | Rachel Lauren Hibbard | Social Worker | 320 S Locust St, Carlinville, IL 62626-1648 | 2018-10-05 |
| 1578918892 | Elizabeth Mcintosh | Social Worker | 320 S Locust St, Carlinville, IL 62626-1648 | 2016-04-25 |
| 1295129690 | Anne Greenwalt | Nurse Practitioner | 320 S Locust St, Carlinville, IL 62626-1648 | 2015-03-24 |
| 1093140253 | Nicole Anne Robertson | Counselor | 320 S Locust St, Carlinville, IL 62626-1648 | 2013-09-06 |
| 1326366287 | Molly A. Ondrey | Counselor | 320 S Locust St, Carlinville, IL 62626-1648 | 2010-05-17 |
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|---|---|---|---|---|
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| 1184266348 | Susan Lynne Fite | Pharmacist | 18600 Shipman Blacktop Road, Carlinville, IL 62626 | 2019-10-09 |
| 1669013215 | Rebecca Lynn Sanson | Pharmacist | 18600 Shipman Blacktop, Carlinville, IL 62626 | 2019-10-04 |
| 1497396048 | Jill Louise Kasting | Pharmacist | 18600 Shipman Blacktop Rd, Carlinville, IL 62626 | 2019-10-04 |
| 1134561822 | Fenton Family Chiropractic PC | Chiropractor | 490 West Side Square, Carlinville, IL 62626 | 2013-07-23 |
| 1992020499 | Carlinville Area Hospital Association | Clinic/Center | 1115 Morgan Street #2, Carlinville, IL 62626 | 2010-03-29 |
| 1730213026 | Carlinville Medical Clinic, Inc. | Nurse Practitioner | 604 N. Broad, Carlinville, IL 62626 | 2007-03-16 |
| 1720155906 | Rodney Lee Bailey | Dentist | 201 Mccausland, Suite A, Carlinsville, IL 62626 | 2006-11-30 |
| 1255412599 | Nicolas E Kravanya Dmd LLC | Dentist | 204 Oakland Ave, Carlinville, IL 62626 | 2006-10-17 |
| 1558456210 | Locust Street Resource Center | Clinic/Center | 320 South Locust Street, Carlinville, IL 62626 | 2006-10-04 |
| Find all providers in zip 62626 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | CARLINVILLE |
| Zip Code | 62626 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.