Southeastern Illinois Center for Pastoral Counseling

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

180003304 Issued in IL

Legal business name

SOUTHEASTERN ILLINOIS CENTER FOR PASTORAL COUNSELING

Practice address

100 S Church St
Carmi, IL 62821-1658

Phone

(618) 382-5548

NPI assigned

Jul 19, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Brenda L. Knuckles, LCPC

Title

Counselor/Therapist

Phone

(618) 382-5548

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1216425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216425600000",
    "number": "1275798266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S CHURCH ST",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "628211658",
            "telephone_number": "618-382-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S CHURCH ST",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "628211658",
            "telephone_number": "618-382-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ILLINOIS CENTER FOR PASTORAL COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-19",
        "last_updated": "2008-07-19",
        "status": "A",
        "authorized_official_last_name": "KNUCKLES",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "COUNSELOR/THERAPIST",
        "authorized_official_telephone_number": "618-382-5548",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "180003304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Seibert, RN
• Rachel A Sinclair, NP
• Fred L Smith, DC
• Jerica Sneed
• Mary Ann South-Gross
• Southern Illinois Primary Care Associates, P.C.
• Jordon Andrew Sowders
• Sarah Spicer, LCSW
• Shawn Stanley, PT
• Candice N Stocke

• Mental Health Clinic/Center (Including Community Mental Health Center) in Carmi, IL
• Providers in Carmi, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2008; 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.