Ap Therapeutic Practice LLC
Organization Active NPI Clinical Social Worker · Sullivan, IL
NPI 1134833718 · NPPES record last updated Jun 20, 2025
Key facts
- NPI
- 1134833718
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- AP THERAPEUTIC PRACTICE LLC
- Practice address
- 16 Kas Villa Acres
Sullivan, IL 61951-9107 - Phone
- (601) 207-0774
- NPI assigned
- Jan 9, 2023
- Organization subpart
- No
Authorized official
- Name
- Alexandria Poe, LCSW
- Title
- Owner
- Phone
- (601) 207-0774
Practitioners 2
-
Alexandria Elizabeth Poe, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250807001368 | IL | Part B Supplier - Clinic/Group Practice | 8123526498 |
Receives reassigned benefits from 1 practitioner Practice locations: Sullivan, IL |
National Provider Directory
Locations
114 N Main St
Sullivan, IL 61951
Phone (601) 207-0774
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
16 Kas Villa Acres
Sullivan, IL 61951-9107
Mailing address
16 Kas Villa Acres
Sullivan, IL 61951-9107
Phone (601) 207-0774
Other providers in Sullivan, IL
- Shalom Aguirre
- Tyler Jacob Alberson
- Janice Althoff
- Penny Arlene Arthur
- Hollie Atchison
- Thomas C. Best
- Erin Booker
- Boyd Optometric Inc
All providers in Sullivan, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.