Rosella Leeann Book

Individual provider Active NPI Mental Health Counselor · Fairfield, IL

NPI 1376003202 · NPPES record last updated Oct 28, 2020

Key facts

NPI
1376003202
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
407 N Basin Rd
Fairfield, IL 62837-9639
Phone
(618) 516-3526
Fax
(618) 516-3525
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

407 N Basin Rd
Fairfield, IL 62837-9639

Mailing address

407 N Basin Rd
Fairfield, IL 62837-9639
Phone (618) 516-5326

Other practice location 1

1705 College Ave
Carmi, IL 62821-2258
Phone (618) 382-7311

Other providers in Fairfield, IL

All providers in Fairfield, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.