South Eastern Illinois Counseling Center Inc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SOUTH EASTERN ILLINOIS COUNSELING CENTER INC

Practice address

901 W 3Rd St
Flora, IL 62839-1287

Phone

(618) 662-2871

Fax

(618) 662-4748

NPI assigned

Feb 4, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Glenn Jackson, M. DIV. LSW, LCPC

Title

Executive Director

Phone

(618) 395-4309

Specialties & licenses 5

Addresses

Other names 1

• CLAY FAMILY COUNSELING CENTER Other name

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1457539330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX M",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624500913",
            "telephone_number": "618-395-4306",
            "fax_number": "618-395-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W 3RD ST",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "628391287",
            "telephone_number": "618-662-2871",
            "fax_number": "618-662-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH EASTERN ILLINOIS COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-395-4309",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M. DIV. LSW, LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLAY FAMILY COUNSELING CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Linda S Siemer, CNP
• Christina Rae Sisk
• Jennifer Smith, LPN
• Kristina Marie Snell, RMA
• South Eastern Illinois Counseling Center Inc
• Ryan Kent Spicer, B.S.M.S. CCC/SLP-L
• Carrie Dawn Spitzner, LPN
• Springfield Clinic LLP
• Springfield Clinic LLP
• Carmen Stanley, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.