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Search › Illinois › 1041S0200X

Amy Prudencio, LCSW

NPI 1295244242 · on the registry since 2017

Practice

Address
1301 E. Walnut Street
Carbondale, IL 62901
Phone
(618) 457-3371
Fax
(618) 549-1608
Organisation at this address
Shawnee Health Service And Development Corp
Inferred from a shared address, not stated in the registry.
Clinicians at this address
6

Registry record

Primary taxonomy
1041S0200X
1041S0200X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2022-07-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois