Ingram Counseling Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

180.010041 Issued in IL

Legal business name

INGRAM COUNSELING SERVICES, LLC

Practice address

1161 Fortune Blvd Ste 400
Shiloh, IL 62269-7385

Phone

(314) 722-8281

Fax

(618) 206-8476

NPI assigned

Aug 27, 2018

Organization subpart

No

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

Authorized official

Name

Angela M Ingram

Title

LCPC/Counselor

Phone

(314) 722-8281

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535328000000",
    "number": "1720569726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 FORTUNE BLVD STE 400",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622697385",
            "telephone_number": "314-722-8281",
            "fax_number": "618-206-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 FORTUNE BLVD STE 400",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622697385",
            "telephone_number": "314-722-8281",
            "fax_number": "618-206-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGRAM COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LCPC/COUNSELOR",
        "authorized_official_telephone_number": "314-722-8281"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "180.010041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Marie Hostert, FNP
• HSM Centers
• HSM Centers LLC
• Shiao-Yun Huang, DPT
• Meredith Hutton
• James Leon Jablonski II, M.D.
• Elizabeth Jeremiah, MA, QMHP, LCPC, LPHA
• Jennifer Jeanne Jouett, PA-C
• Brooke Juneau, DMD
• Tina Marie Kampwerth, LCPC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Shiloh, IL
• Providers in Shiloh, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.