Crab Orchard Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149014398 Issued in IL

Legal business name

CRAB ORCHARD COUNSELING LLC

Practice address

4501 W Deyoung St
Suite 208
Marion, IL 62959-6360

Phone

(618) 967-4890

Fax

(815) 846-0744

NPI assigned

Mar 13, 2014

Last updated

Mar 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Ricci

Title

Billing Manager

Phone

(847) 894-0218

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1649696774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 W DEYOUNG ST",
            "address_2": "SUITE 208",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596360",
            "telephone_number": "618-967-4890",
            "fax_number": "815-846-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 W DEYOUNG ST",
            "address_2": "SUITE 208",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596360",
            "telephone_number": "618-967-4890",
            "fax_number": "815-846-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAB ORCHARD COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "RICCI",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "847-894-0218"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Carol Cowsert, BACHELORS OF SCIENCE
• Bradley Cox, DMD
• Danielle Cox
• Cassi Lyn Cozart, PHARMD
• Lynn Cozart
• Crab Orchard Cusd 3
• Crabtree Family Optometry (Crabtree and Merriman Optometry)
• Jessie Crabtree, OD
• Trevor Ray Crabtree, O.D.
• Craig W Furry

• Clinical Social Worker in Marion, IL
• Providers in Marion, 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 Mar 13, 2014; 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.