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NPI Code Detail

MEDICARE: CARRIE JANELLE ACKERMAN LCSW

MEDICARE: CARRIE JANELLE ACKERMAN LCSW
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
11041C0700XClinical Social Worker149.011724IL

General Provider Information

NPI Number : 1841327533
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE JANELLE ACKERMAN LCSW
Provider Business Mailing Address
First Line : 920 E OAK ST
Second Line :
City : GREENVILLE
State : IL
Zip : 62246-1549
Country : US
Telephone Number : 618-664-1455
Fax Number : 618-664-1744
Provider Business Practice Location Address
First Line : 1520 S 4TH ST
Second Line :
City : GREENVILLE
State : IL
Zip : 62246-2618
Country : US
Telephone Number : 618-664-1455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 02/01/2021

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Directions to “ CARRIE JANELLE ACKERMAN LCSW” Practice Location

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