Interfaith Counseling Center

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

INTERFAITH COUNSELING CENTER

Practice address

205 S Main St
Ste. B
Edwardsville, IL 62025-1921

Phone

(618) 659-1606

Fax

(314) 835-1016

NPI assigned

Oct 19, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Brian Glen Storey, D.MIN., LCPC, LMFT

Title

Director/President

Phone

(618) 659-1606

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740279074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S MAIN ST",
            "address_2": "STE. B",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251921",
            "telephone_number": "618-659-1606",
            "fax_number": "314-835-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S MAIN ST",
            "address_2": "STE. B",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251921",
            "telephone_number": "618-659-1606",
            "fax_number": "314-835-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERFAITH COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOREY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "GLEN",
        "authorized_official_title_or_position": "DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "618-659-1606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.MIN., LCPC, LMFT"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Voluntary or Charitable Agency in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Voluntary or Charitable Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.