Talapatra, Poorva

Talapatra, Poorva is an individual health care provider with primary practice located at 400 S Lewis Ln , Carbondale IL 62901-3547. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Talapatra, Poorva can be contacted via phone (618) 519-9900.

Contact Information

Primary practice address
400 S Lewis Ln Carbondale IL 62901-3547
Phone: (618) 519-9900
Fax: (618) 529-1384
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 178005097 Illinois

Profile Details

NPI number 1013210194
LBN Legal business name Talapatra, Poorva
Credentials M.ED., LCPC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2010
Last updated Aug 25th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013210194 NPPES
Illinois MEDICAID 370966854024

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