NPIMap

Organization Active NPI

Riverbend Head Start & Family Services

  • Mental Health Counselor
  • Alton, IL
National Provider Identifier
1164476115
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RIVERBEND HEAD START & FAMILY SERVICES
Practice address
3550 College Ave
Ste C
Alton, IL 62002-7304
Phone
(618) 463-5927
Fax
(618) 463-5965
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Monica Moffet, LCSW LCPC
Title
Clinical Director
Phone
(618) 463-5927

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3550 College Ave
Ste C
Alton, IL 62002-7304

Mailing address

550 Landmarks Blvd
Alton, IL 62002-7304
Phone (618) 463-5927

Other identifiers 1

IdentifierTypeStateIssuer
3741717016MedicaidIL

Other names 1

  • Transitions Counseling Other name

National Provider Directory

National Provider Directory
Tax ID family
Riverbend Head Start Family Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164476115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 LANDMARKS BLVD",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027304",
            "telephone_number": "618-463-5927",
            "fax_number": "618-463-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 COLLEGE AVE",
            "address_2": "STE C",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027304",
            "telephone_number": "618-463-5927",
            "fax_number": "618-463-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERBEND HEAD START & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOFFET",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "618-463-5927",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3741717016",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Transitions Counseling",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.