SUPPORTIVE CARE OF ILLINOIS PC NPI 1861199911

NPI Information

  • NPI: 1861199911
  • Provider Name: SUPPORTIVE CARE OF ILLINOIS PC
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 410 N 2ND ST
    MARSHALL, IL
    ZIP 62441
  • Phone: (866) 708-1240

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NPI Details

SUPPORTIVE CARE OF ILLINOIS PC is a clinical psychologist in Marshall, IL. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. SUPPORTIVE CARE OF ILLINOIS PC NPI is 1861199911. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

410 N 2ND ST
MARSHALL, IL
ZIP 62441-010
Phone: (866) 708-1240

The provider's authorized official is Dov Newmark .
The authorized official title is Ceo and has the following contact phone number (718) 298-2753.

The enumeration date for this NPI number is 2/9/2023 and was last updated on 2/9/2023.

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
11041C0700XSocial WorkerClinicalNo
2363L00000XNurse PractitionerNo
3103TC0700XPsychologistClinicalYes

What is NPI?

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This page was last updated on: 3/30/2025

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