S E ILLINOIS COUNSELING CTRS INC. NPI 1942479597

NPI Information

NPI: 1942479597
Provider Name: S E ILLINOIS COUNSELING CTRS INC.

Other Name: LAWRENCE FAMILY COUNSELING CTR

Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
1501 OLIVE ST
LAWRENCEVILLE, IL
ZIP 62439
Phone: (618) 943-3451
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S E ILLINOIS COUNSELING CTRS INC. is an addiction (substance use disorder) counselor in Lawrenceville, IL. S E ILLINOIS COUNSELING CTRS INC. NPI is 1942479597. The provider is registered as an organization entity type.
The provider Other Name Is Lawrence Family Counseling Ctr.

The provider's business location address is:

1501 OLIVE ST
LAWRENCEVILLE, IL
ZIP 62439-269
Phone: (618) 943-3451
Fax: (618) 943-4368

The provider's authorized official is Glenn Jackson .
The authorized official title is Executive Director and has the following contact phone number (618) 395-4306.

The enumeration date for this NPI number is 2/28/2008 and was last updated on 5/5/2016.

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	Primary
1	251S00000X	Community/Behavioral Health		No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
3	261QM0850X	Clinic/Center	Adult Mental Health	No
4	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
5	101YA0400X	Counselor	Addiction (Substance Use Disorder)	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
1	=========012	MEDICAID	ILLINOIS
2	IL2222	MEDICARE PIN	ILLINOIS
3	=========034	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: 5/5/2024

NPI Synchronization or Removal

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