Provider Demographics
NPI:1740168715
Name:SUPERIOR ASSOCIATES MENTAL HEALTH & WELLNESS, PLLC
Entity type:Organization
Organization Name:SUPERIOR ASSOCIATES MENTAL HEALTH & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:KI RISTIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN-LAMPE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, PMHNP-BC
Authorized Official - Phone:618-322-7217
Mailing Address - Street 1:21580 BIRG ST
Mailing Address - Street 2:
Mailing Address - City:CARLYLE
Mailing Address - State:IL
Mailing Address - Zip Code:62231-6471
Mailing Address - Country:US
Mailing Address - Phone:618-322-7217
Mailing Address - Fax:618-227-7787
Practice Address - Street 1:4941 BENCHMARK CENTRE DR STE 200
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-2038
Practice Address - Country:US
Practice Address - Phone:618-359-3598
Practice Address - Fax:618-227-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty