SOUTH EASTERN ILLINOIS COUNSELING CENTER INC NPI 1235317116

NPI Information

NPI: 1235317116
Provider Name: SOUTH EASTERN ILLINOIS COUNSELING CENTER INC

Other Name: LAWRENCE FAMILY COUNSELING CENTER

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1501 OLIVE ST
LAWRENCEVILLE, IL
ZIP 62439
Phone: (618) 943-3451
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SOUTH EASTERN ILLINOIS COUNSELING CENTER INC is a mental health counselor in Lawrenceville, IL. SOUTH EASTERN ILLINOIS COUNSELING CENTER INC NPI is 1235317116. The provider is registered as an organization entity type.
The provider Other Name Is Lawrence Family Counseling Center.

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) 395-4309.

The enumeration date for this NPI number is 2/4/2008 and was last updated on 9/15/2011.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	No
2	101Y00000X	Counselor		No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
4	101YP2500X	Counselor	Professional	No
5	101YM0800X	Counselor	Mental Health	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 UPIN	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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