NPIMap

Organization Active NPI

Mental Health Centers of Central Illinois

Doing business as Memorial Behavioral Health Counseling Associates

  • Clinical Social Worker
  • Springfield, IL
National Provider Identifier
1750614798
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
Doing business as
Memorial Behavioral Health Counseling Associates
Practice address
901 N 1St St
Suite 225
Springfield, IL 62702-3759
Phone
(217) 788-4065
Fax
(217) 788-4147
NPI assigned
Sep 9, 2009
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Ann Bowling
Title
Director
Phone
(217) 588-2626

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

901 N 1St St
Suite 225
Springfield, IL 62702-3759

Mailing address

901 N 1St St Ste 225
Springfield, IL 62702-3760
Phone (217) 788-4065

Other names 1

  • Memorial Behavioral Health Counseling Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040127000030 IL Part B Supplier - Clinic/Group Practice 8325940521 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springfield, IL; Jacksonville, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
C C S15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

3225 Hedley Rd
Springfield, IL 62711
Phone (217) 726-6700

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1750614798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N 1ST ST STE 225",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023760",
            "telephone_number": "217-788-4065",
            "fax_number": "217-788-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N 1ST ST",
            "address_2": "SUITE 225",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023759",
            "telephone_number": "217-788-4065",
            "fax_number": "217-788-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-09",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "217-588-2626"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Behavioral Health Counseling Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.