Counseling for a Change

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180006639 Issued in IL

Legal business name

COUNSELING FOR A CHANGE

Practice address

70 Sandy PT
Goreville, IL 62939-3122

Phone

(618) 889-3987

Fax

(618) 351-1419

NPI assigned

Feb 26, 2008

Last updated

Jan 8, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Andrew Selock, MS,CADC,LCPCNPI 1891872362

Title

Owner

Phone

(618) 889-3987

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Former LBN - Danield Andrew Selock Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Andrew Selock, MS/CADC/LCPC

  • Professional Counselor
  • Goreville, IL
  • NPI 1891872362
  NPD (past) Authorized official

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357603200000",
    "number": "1285803072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 SANDY PT",
            "city": "GOREVILLE",
            "state": "IL",
            "postal_code": "629393122",
            "telephone_number": "618-889-3987",
            "fax_number": "618-351-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 SANDY PT",
            "city": "GOREVILLE",
            "state": "IL",
            "postal_code": "629393122",
            "telephone_number": "618-889-3987",
            "fax_number": "618-351-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING FOR A CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2013-01-08",
        "status": "A",
        "authorized_official_last_name": "SELOCK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-889-3987",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS,CADC,LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180006639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "03932079",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11826508",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE, LCPC",
            "identifier": "180006639",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Former LBN - Danield Andrew Selock",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Blake William Cain, MD, MS
• Camarato Drug Inc (Goreville Professional Pharmacy)
• Matthew Camarato, RPH
• CLS Medical Inc. (Goreville Family Practice)
• Amber Conyea, PTA
• CR Vaughn Inc (Vaughn Electric)
• Emily A Finke, DMD
• Amanda Mae Lorene Fowler Test
• Goreville Community Unit No 1
• Stacy L Greer, RN

• Professional Counselor in Goreville, IL
• Providers in Goreville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.