NPIMap

Organization Active NPI

Stress & Trauma Treatment Center, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Eldorado, IL
National Provider Identifier
1851966014
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
STRESS & TRAUMA TREATMENT CENTER, INC.
Practice address
1200 Locust St
Eldorado, IL 62930-1723
Phone
(618) 252-9036
Fax
(618) 216-9993
NPI assigned
May 20, 2021
Last updated
May 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Dr. Donald Matthew Buckman, PH DNPI 1497982847
Title
Executive Director
Phone
(270) 997-1065

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

1200 Locust St
Eldorado, IL 62930-1723

Mailing address

1200 Locust St
Eldorado, IL 62930-1723
Phone (618) 252-9036

National Provider Directory

National Provider Directory

Locations

1200 Locust St
Eldorado, IL 62930
Phone (618) 252-9036

Practitioners & affiliated clinicians

Practitioners 62

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 62

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1851966014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 LOCUST ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301723",
            "telephone_number": "618-252-9036",
            "fax_number": "618-216-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LOCUST ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301723",
            "telephone_number": "618-252-9036",
            "fax_number": "618-216-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRESS & TRAUMA TREATMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "BUCKMAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "270-997-1065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH D"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldorado, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.