Kelly Marie Baker

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Pittsfield, IL

NPI 1841494085 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1841494085
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
121 S Madison
Pittsfield, IL 62363
Phone
(217) 285-4436
Fax
(217) 285-2804
NPI assigned
Jun 12, 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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Centers of Western Illinois Past Accepting new patients
NPI 1457643645 Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

121 S Madison
Pittsfield, IL 62363

Mailing address

1301 N 2353Rd LN
Mendon, IL 62351
Phone (217) 440-6200

Other providers in Pittsfield, IL

All providers in Pittsfield, IL · Addiction (Substance Use Disorder) Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.