MEDICARE: ALICE BADGER LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	180006424	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180006424	OTHER	IL	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1467509109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE BADGER LCPC

Provider Business Mailing Address
First Line	:	6 SUNSET DR
Second Line	:
City	:	MOUNT VERNON
State	:	IL
Zip	:	62864-2215
Country	:	US
Telephone Number	:	616-183-1689
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 BROADWAY ST STE A
Second Line	:
City	:	MOUNT VERNON
State	:	IL
Zip	:	62864-2973
Country	:	US
Telephone Number	:	618-634-7753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	10/14/2025

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Directions to “ ALICE BADGER LCPC” Practice Location

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