McKynzi Ash

Individual provider Active NPI Mental Health Counselor · Mount Vernon, IL

NPI 1962001206 · NPPES record last updated Oct 19, 2020

Key facts

NPI
1962001206
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
4110 N Water Tower PL
Mount Vernon, IL 62864-6295
Phone
(618) 424-8266
NPI assigned
Oct 19, 2020
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
One Hope United Past
since Oct 25, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

4110 N Water Tower PL
Mount Vernon, IL 62864-6295

Mailing address

109 W Wilson St
Fairfield, IL 62837-1816
Phone (618) 919-0251

Other providers in Mount Vernon, IL

All providers in Mount Vernon, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.