S E Illinois Counseling CTRS

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Albion, IL

NPI 1205005758 · NPPES record last updated Apr 20, 2008

Key facts

NPI
1205005758
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
S E ILLINOIS COUNSELING CTRS
Practice address
254 S 5TH St
Albion, IL 62806-1121
Phone
(618) 445-3559
Fax
(618) 445-2912
NPI assigned
Feb 28, 2008
Organization subpart
No

Authorized official

Name
Mr. Glenn Jackson, M. DIV., LSW, LCPC
Title
Executive Director
Phone
(618) 395-4309

Corporate family (same tax ID) 8

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

National Provider Directory

Tax ID family
Southeastern Ill Counse (9 organizations share this tax ID)

Locations

254 S 5th St
Albion, IL 62806
Phone (618) 445-3559

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

254 S 5TH St
Albion, IL 62806-1121

Mailing address

PO Box M
504 Micah Drive
Olney, IL 62450-0913
Phone (618) 395-4306

Other names

  • EDWARDS FAMILY COUNSELING CTR Other name

Other providers in Albion, IL

All providers in Albion, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

Sources for this page

Verify at the official NPI Registry.