Liberty Counseling Center,Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

A-7302-0003-A Issued in IL

Legal business name

LIBERTY COUNSELING CENTER,INC.

Practice address

209 S Washington St
Taylorville, IL 62568-2246

Phone

(217) 287-2550

Fax

(217) 478-2060

NPI assigned

Feb 15, 2011

Last updated

Feb 15, 2011By 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

Mrs. Sandra K. Eyman, MS, CADC, MISA II

Title

President/Director

Phone

(217) 287-2550

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Liberty Counseling Center Inc2 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.

• Liberty Counseling Center, Inc

  • Community/Behavioral Health Agency
  • Jacksonville, IL
  • NPI 1457658189
  NPD tax ID

Locations

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1730486465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S WASHINGTON ST",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625682246",
            "telephone_number": "217-287-2550",
            "fax_number": "217-478-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S WASHINGTON ST",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625682246",
            "telephone_number": "217-287-2550",
            "fax_number": "217-478-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY COUNSELING CENTER,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "EYMAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "217-287-2550",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CADC, MISA II"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-7302-0003-A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C/A-7302-0003-A",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C/A-7302-0001-A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lanny S Odin MD SC (Central Illinois Retina Institute)
• Timothy W Lawrence
• Leslie Jackson, MD (Taylorville Family Care, LTD)
• Kelsey Marie Levault, MD
• Carrie J Lewis, MA OTR/L
• Jon Livingston, RPH
• Alyssa Elizabeth Loman
• Diane Michelle Lowry, M.S. CCC SLP
• Karen M. Manson, FNP-BC
• Lauren Nicole Mantei, OTR

• Community/Behavioral Health Agency in Taylorville, IL
• Providers in Taylorville, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.