Melinda Luanne Bloos, PH.D.

Individual provider Active NPI Clinical Psychologist · Murphysboro, IL

NPI 1437247012 · NPPES record last updated Oct 2, 2023

Key facts

NPI
1437247012
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
071004937 (IL)
Practice address
1400 N Wood Rd
Murphysboro, IL 62966-6290
Phone
(618) 457-6443
Fax
(618) 351-1419
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1400 N Wood Rd
Murphysboro, IL 62966-6290
Phone 6184576443302

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040218000514 IL Practitioner - Clinical Psychologist 2264327212 Practice locations: Murphysboro, IL

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Healing Arts, LLC Past Accepting new patients
Burke Behavioral Health, LLC Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071004937 IL Yes

Addresses

Primary practice location

1400 N Wood Rd
Murphysboro, IL 62966-6290

Mailing address

1400 N Wood Rd
Murphysboro, IL 62966-6290
Phone (618) 457-6443

Other providers in Murphysboro, IL

All providers in Murphysboro, IL · Clinical Psychologist in Illinois

Sources for this page

Verify at the official NPI Registry.