Organization
INK & IVY PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKLYN STANLEY APRN (PMHNP)
(618) 852-1395
Entity
Organization
Contact information
Practice address
203 S MAIN ST, DIETERICH, IL 62424-1128
(618) 852-1395
Mailing address
113 E WALNUT ST, NOBLE, IL 62868-1709
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/21/2026
Last updated
05/21/2026
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