NPIMap

Organization Active NPI

Counseling Associates of Southern Illinois

  • Professional Counselor
  • O'Fallon, IL
National Provider Identifier
1861769184
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.007978 Issued in IL
Legal business name
COUNSELING ASSOCIATES OF SOUTHERN ILLINOIS
Practice address
1669 Windham Way Ste B
O Fallon, IL 62269-3072
Phone
(618) 622-2579
Fax
(618) 624-8506
NPI assigned
Dec 1, 2011
Last updated
Dec 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Sheri MillerNPI 1841256419
Title
Partner
Phone
(618) 622-2579

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 180.007978 IL Primary

Addresses

Primary practice location

1669 Windham Way Ste B
O Fallon, IL 62269-3072

Mailing address

1669 Windham Way Ste B
O Fallon, IL 62269-3072
Phone (618) 622-2579

Other identifiers 2

IdentifierTypeStateIssuer
732-136OtherMOHEALTHLINK
0823180OtherILBLUE CROSS

National Provider Directory

National Provider Directory
Tax ID family
Clipper and Miller PC2 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.

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1861769184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 WINDHAM WAY STE B",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693072",
            "telephone_number": "618-622-2579",
            "fax_number": "618-624-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 WINDHAM WAY STE B",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693072",
            "telephone_number": "618-622-2579",
            "fax_number": "618-624-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING ASSOCIATES OF SOUTHERN ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "618-622-2579"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.007978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "732-136",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0823180",
            "state": "IL"
        }
    ],
    "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 Dec 1, 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.