S E ILLINOIS COUNSELING CTRS NPI 1750550208

NPI Information

NPI: 1750550208
Provider Name: S E ILLINOIS COUNSELING CTRS

Other Name: CRAWFORD FAMILY COUNSELING CTR

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
204 W HIGHLAND AVE
ROBINSON, IL
ZIP 62454
Phone: (618) 546-1021
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S E ILLINOIS COUNSELING CTRS is a mental health (including community mental health center) clinic center in Robinson, IL. S E ILLINOIS COUNSELING CTRS NPI is 1750550208. The provider is registered as an organization entity type.
The provider Other Name Is Crawford Family Counseling Ctr.

The provider's business location address is:

204 W HIGHLAND AVE
ROBINSON, IL
ZIP 62454-710
Phone: (618) 546-1021
Fax: (618) 544-3791

The provider's authorized official is Glenn Jackson .
The authorized official title is Executive Director and has the following contact phone number (618) 395-4506.

The enumeration date for this NPI number is 2/28/2008 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	251S00000X	Community/Behavioral Health		No
3	261QM0850X	Clinic/Center	Adult Mental Health	No
4	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
5	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
1	=========013	MEDICAID	ILLINOIS
2	IL2222	MEDICARE UPIN	ILLINOIS
3	=========004	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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