Coles County Mental Health Association Inc
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Olney, IL
NPI 1609385269 · NPPES record last updated Nov 18, 2024
Key facts
- NPI
- 1609385269
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- COLES COUNTY MENTAL HEALTH ASSOCIATION INC
- Practice address
- 801 S West St Ste 121
Olney, IL 62450-1334 - Phone
- (217) 238-5700
- Fax
- (217) 238-5767
- NPI assigned
- Sep 27, 2017
- Organization subpart
- No
Authorized official
- Name
- Joseph King, LCPC
- Title
- Executive Director
- Phone
- (217) 238-5700
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 9
Practitioners 3
-
Barbara E Estes, M.S.
-
Christine Hughes, LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070516000072 | IL | Part B Supplier - Clinic/Group Practice | 9537194329 |
Receives reassigned benefits from 8 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Effingham, IL; Olney, IL; Mattoon, IL |
National Provider Directory
- Tax ID family
- Coles County Mental Health Association Inc
Locations
750 Broadway Ave E
Mattoon, IL 61938
Phone (217) 238-5735
801 S West St
Ste 121
Olney, IL 62450
1200 N East St
Olney, IL 62450
Phone (618) 392-2940
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
801 S West St Ste 121
Olney, IL 62450-1334
Mailing address
801 S West St Ste 121
Olney, IL 62450-1334
Phone (217) 238-5700
Other names
- LifeLinks Mental Health
Other providers in Olney, IL
- Paige Breanne Clayton
- Rachel Clow
- Debra K Coad
- Carla Cole
- Jack A Cole
- Colwell Counseling & Consulting Services, Inc.
- Cheryl Colwell
- Joanna S Condrey
- County of Jasper
- County of Richland
All providers in Olney, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.