SOUTHEASTERN ILLINOIS CENTER FOR PASTORAL COUNSELING NPI 1275798266

NPI Information

NPI: 1275798266
Provider Name: SOUTHEASTERN ILLINOIS CENTER FOR PASTORAL COUNSELING
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
100 S CHURCH ST
CARMI, IL
ZIP 62821
Phone: (618) 382-5548
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SOUTHEASTERN ILLINOIS CENTER FOR PASTORAL COUNSELING is a mental health (including community mental health center) clinic center in Carmi, IL. SOUTHEASTERN ILLINOIS CENTER FOR PASTORAL COUNSELING NPI is 1275798266. The provider is registered as an organization entity type.

The provider's business location address is:

100 S CHURCH ST
CARMI, IL
ZIP 62821-658
Phone: (618) 382-5548

The provider's authorized official is Brenda L. Knuckles .
The authorized official title is Counselor/therapist and has the following contact phone number (618) 382-5548.

The enumeration date for this NPI number is 7/19/2008 and was last updated on 7/19/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	180003304	ILLINOIS	Yes

What is NPI?

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This page was last updated on: 5/5/2024

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