Intensive Out-Patient Care

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INTENSIVE OUT-PATIENT CARE

Practice address

156 N Main St
Suite 202
Edwardsville, IL 62025-1972

Phone

(618) 656-7064

Fax

(618) 656-9084

NPI assigned

Mar 12, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Jennifer Mary Manning, LCSW

Title

Program Director

Phone

(618) 656-7064

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477685527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 N MAIN ST",
            "address_2": "SUITE 202",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251972",
            "telephone_number": "618-656-7064",
            "fax_number": "618-656-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 N MAIN ST",
            "address_2": "SUITE 202",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251972",
            "telephone_number": "618-656-7064",
            "fax_number": "618-656-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENSIVE OUT-PATIENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "618-656-7064",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Medical Group LTD
• Integrated Medical Group, LTD
• Integrative Performance Medical Group, PLLC
• Integrity Nurse Staffing
• Intensive Out-Patient Care
• Interfaith Counseling Center
• Malina Lynn Isaak
• Gabrielle Andrea Ivy, RBT
• Lauren Mae Iwakiri
• Debra Marlene Jackson, MS-CCC/SLP

• Clinical Social Worker in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.