FUNDAMENTAL BEHAVIORAL HEALTH NPI 1194404319

NPI Information

NPI: 1194404319
Provider Name: FUNDAMENTAL BEHAVIORAL HEALTH
Classification: Clinic/Center - 261QM0855X
Specialization: Adolescent and Children Mental Health
Entity Type: Organization
Other Name: FUNDAMENTAL BEHAVIORAL HEALTH
Address: 604 BEVERLY LN
COLLINSVILLE, IL
ZIP 62234
Phone: (618) 401-8225

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NPI Details

FUNDAMENTAL BEHAVIORAL HEALTH is an adolescent and children mental health clinic center in Collinsville, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. FUNDAMENTAL BEHAVIORAL HEALTH NPI is 1194404319. The provider is registered as an organization entity type.
The provider Other Name Is Fundamental Behavioral Health.

The provider's business location address is:

604 BEVERLY LN
COLLINSVILLE, IL
ZIP 62234-912
Phone: (618) 401-8225

The provider's authorized official is Joellen Juenger .
The authorized official title is Fnp-bc, Pmhnp-bc and has the following contact phone number (618) 401-8225.

The enumeration date for this NPI number is 7/14/2023 and was last updated on 1/9/2024.

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	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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