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General NPI Number Information
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NPI Number | 1740168715
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Entity Type | Organization
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Legal Business Name | SUPERIOR ASSOCIATES MENTAL HEALTH & WELLNESS, PLLC
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 4941 BENCHMARK CENTRE DR STE 200
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City | SWANSEA
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State | IL
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Zip | 62226-2038
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Country | US
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Telephone | 618-359-3598
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Fax | 618-227-7787
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Provider Business Mailing Address
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Address Line | 21580 BIRG ST
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City | CARLYLE
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State | IL
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Zip | 62231-6471
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Country | US
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Telephone | 618-322-7217
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Fax | 618-227-7787
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Authorized Official
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Title or Position | OWNER, CEO
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Name | KI RISTIA ALLEN-LAMPE
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Credential | FNP-C, PMHNP-BC
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Telephone | 618-322-7217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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