LUTHERAN CHILD AND FAMILY SERVICE OF ILLINOIS NPI 1497084347

NPI Information

NPI: 1497084347
Provider Name: LUTHERAN CHILD AND FAMILY SERVICE OF ILLINOIS
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
618 S. 42ND ST
MT VERNON, IL
ZIP 62864
Phone: (618) 242-3284
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LUTHERAN CHILD AND FAMILY SERVICE OF ILLINOIS is a mental health (including community mental health center) clinic center in Mt Vernon, IL. LUTHERAN CHILD AND FAMILY SERVICE OF ILLINOIS NPI is 1497084347. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

618 S. 42ND ST
MT VERNON, IL
ZIP 62864
Phone: (618) 242-3284
Fax: (618) 242-3288

The provider's authorized official is James Allen Webster .
The authorized official title is System Support Analyst and has the following contact phone number (708) 907-1583.

The enumeration date for this NPI number is 12/23/2009 and was last updated on 11/11/2022.

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	104100000X	Social Worker				No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No
3	101YM0800X	Counselor	Mental Health			No
4	101YP2500X	Counselor	Professional			No
5	1041C0700X	Social Worker	Clinical			No
6	106H00000X	Marriage & Family Therapist				No
7	253J00000X	Foster Care Agency		012998-11	ILLINOIS	No
8	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2B05-CHR-025	MEDICAID	ILLINOIS

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: 4/28/2024

NPI Synchronization or Removal

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