NPIMap

Organization Active NPI

Southwest Family & Childrens Testing & Therapy Clinic

  • Clinical Psychologist
  • O'Fallon, IL
National Provider Identifier
1821207309
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SOUTHWEST FAMILY & CHILDRENS TESTING & THERAPY CLINIC
Practice address
501 Emily Drive
Ofallon, IL 62269
Phone
(618) 632-7400
Fax
(618) 632-8376
NPI assigned
May 22, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Philip L Eckert, LCPC
Title
Executive Director
Phone
(618) 632-7400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IL
Clinical Psychologist 103TC0700X IL Primary

Addresses

Primary practice location

501 Emily Drive
Ofallon, IL 62269

Mailing address

PO Box 339
501 Emily Drive
Ofallon, IL 62269
Phone (618) 632-7400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1821207309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "address_2": "501 EMILY DRIVE",
            "city": "OFALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-632-7400",
            "fax_number": "618-632-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 EMILY DRIVE",
            "city": "OFALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-632-7400",
            "fax_number": "618-632-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST FAMILY & CHILDRENS TESTING & THERAPY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ECKERT",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-632-7400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.