SHYLA ROSE BOUGOR LCPC NPI 1295380863

NPI Information

  • NPI: 1295380863
  • Provider Name: SHYLA ROSE BOUGOR, LCPC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Individual
  • Address: 10257 STATE ROUTE 3
    RED BUD, IL
    ZIP 62278
  • Phone: (618) 282-6233

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NPI Details

Shyla Rose Bougor, LCPC is a mental health (including community mental health center) clinic center in Red Bud, IL. Shyla Rose Bougor, LCPC NPI is 1295380863. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10257 STATE ROUTE 3
RED BUD, IL
ZIP 62278-418
Phone: (618) 282-6233
Fax: (888) 388-1971

The enumeration date for this NPI number is 8/9/2019 and was last updated on 9/24/2025.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)178017516ILLINOISNo
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)180015824ILLINOISYes

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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