PERRY COUNTY COUNSELING CENTER INC NPI 1851533996

NPI Information

NPI: 1851533996
Provider Name: PERRY COUNTY COUNSELING CENTER INC

Doing Business As: SOUTHERN ILLINOIS BEHAVIORAL SERVICES

Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
8271 E JACKSON STREET RD
DU QUOIN, IL
ZIP 62832
Phone: (618) 542-6722
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PERRY COUNTY COUNSELING CENTER INC is a professional counselor in Du Quoin, IL. PERRY COUNTY COUNSELING CENTER INC NPI is 1851533996. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southern Illinois Behavioral Services.

The provider's business location address is:

8271 E JACKSON STREET RD
DU QUOIN, IL
ZIP 62832-811
Phone: (618) 542-6722
Fax: (618) 542-6623

The provider's authorized official is John R Venskus .
The authorized official title is Executive Director and has the following contact phone number (618) 542-4357.

The enumeration date for this NPI number is 4/6/2009 and was last updated on 4/6/2009.

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	1041C0700X	Social Worker	Clinical	149008165	ILLINOIS	No
2	1041C0700X	Social Worker	Clinical	149010561	ILLINOIS	No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	149012186	ILLINOIS	No
4	101YP2500X	Counselor	Professional	180004129	ILLINOIS	No
5	101YP2500X	Counselor	Professional	180004366	ILLINOIS	No
6	103TP0016X	Psychologist	Prescribing (Medical)	036077893		No
7	101YP2500X	Counselor	Professional	180003682	ILLINOIS	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	012300790	MEDICAID	ILLINOIS
2	961670	MEDICARE PIN	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: 5/5/2024

NPI Synchronization or Removal

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