Clinical Counseling, LTD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-002360 Issued in IL

Legal business name

CLINICAL COUNSELING, LTD

Practice address

3001 Spring Mill Dr
Springfield, IL 62704-6566

Phone

(217) 793-8900

Fax

(217) 793-8389

NPI assigned

Oct 1, 2008

Organization subpart

No

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

Authorized official

Name

Leslie J Fyans Jr., PHD

Title

Officer

Phone

(217) 793-8900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1396996971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 SPRING MILL DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046566",
            "telephone_number": "217-793-8900",
            "fax_number": "217-793-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SPRING MILL DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046566",
            "telephone_number": "217-793-8900",
            "fax_number": "217-793-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL COUNSELING, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "FYANS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "217-793-8900",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-002360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8472017",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Cleveland, LCSW
• Matthew Cleveland, MD
• Catherine Clevenger, LCSW
• Lauren Clevenger, LPC
• Clinical Counseling Group & Dui Providers, LLC
• Clinical Pathologists of Central Illinois, S.C.
• Clinical Radiologists, S.C.
• Clinical Radiologists, S.C.
• Clinical Radiologists, S.C.
• Clinical Systems, Inc.

• Clinical Psychologist in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.