Kathleen M Edwards – Marriage & Family Therapist

Key facts

NPI: 1528186558
Entity type: Individual (NPI type 1)
Primary specialty: Marriage & Family Therapist 106H00000X
Practice address: 3001 Spring Mill Drive
Suite D
Springfield, IL 62704-6599
Phone: (217) 546-3100
Fax: (217) 546-3284
NPI assigned: Mar 27, 2007
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Bohlen & Associates, S.C. Psychiatry Physician · Springfield, IL · NPI 1396922688

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
166000102	IL	MD	Marriage & Family Therapist

Practice roles

Organization	Specialty	Status	New patients
Bohlen & Associates, S.C.		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Marriage & Family Therapist	106H00000X		IL	Yes

Addresses

Primary practice location

3001 Spring Mill Drive
Suite D
Springfield, IL 62704-6599

Mailing address

3001 Spring Mill Drive
Suite D
Springfield, IL 62704-6599
Phone (217) 546-3100

Other identifiers

Identifier	Type	State	Issuer
08400618	Other	IL	BCBS INS CO

Other providers in Springfield, IL

Richard T Eden, MD
Jennifer C Edmonds, CCC-A
Desiree Marie Edmondson, MD
Edward a Trudeau MD SC
David Joseph Edwards, MA, PROFESSIONAL COU
Robert P Edwards, O.D.
Timothy Edwards, O.D.
Reagan Egan
Sarah Rae Eggleston, PA-C
Nicole Eghtesadi, MD

All providers in Springfield, IL · Marriage & Family Therapist in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.