Abbcon Counseling Corporation

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

A-6036-0004-A Issued in IL

Legal business name

ABBCON COUNSELING CORPORATION

Practice address

201 N Logan St Ste a
Mattoon, IL 61938-4598

Phone

(217) 317-2089

NPI assigned

May 7, 2015

Organization subpart

No

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

Authorized official

Name

Ashley Epperson, BS, CADC

Title

Director

Phone

(217) 345-3156

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Abbcon Counseling Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Abbcon Counseling, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Charleston, IL
  • NPI 1457690216
  NPD tax ID

Locations

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1487032769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 MONROE AVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202034",
            "telephone_number": "217-345-3156",
            "fax_number": "217-345-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N LOGAN ST STE A",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384598",
            "telephone_number": "217-317-2089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 West South Central",
            "address_purpose": "LOCATION",
            "city": "Tuscola",
            "state": "IL",
            "postal_code": "61953",
            "country_code": "US",
            "telephone_number": "217-253-3111",
            "fax_number": "217-253-3009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 N Logan St Ste B",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384598",
            "country_code": "US",
            "telephone_number": "217-317-2089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ABBCON COUNSELING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "EPPERSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "217-345-3156",
        "authorized_official_credential": "BS, CADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-6036-0004-A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPR LICENSE NUMBER",
            "identifier": "A-6036-0013-A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mustafa Abdul-Hussein, MD
• Kristina D Adams Smith, RD
• Ashley Adams, APRN
• Arnold V Agapito, MD
• Aziz Ahmed, MD

• All providers in Mattoon, IL
• Substance Use Disorder Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.