NPIMap

Organization Active NPI

Centerstone of Illinois, Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Marion, IL
National Provider Identifier
1871058149
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
CENTERSTONE OF ILLINOIS, INC
Practice address
1205 W Main St
Marion, IL 62959-1137
Phone
(877) 467-3123
NPI assigned
Jan 31, 2019
Last updated
Sep 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Stacy D Phillips
Title
Ar Manager
Phone
(618) 937-6483

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

1205 W Main St
Marion, IL 62959-1137

Mailing address

1205 W Main St
Marion, IL 62959-1137

National Provider Directory

National Provider Directory
Tax ID family
Franklin Williamson Hum62 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

402 E Plaza Dr
Ste 5
Carterville, IL 62918
Phone (618) 319-6060

1205 W Main St
Marion, IL 62959
Phone (618) 319-6060

Practitioners & affiliated clinicians

Practitioners 7

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": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1871058149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591137",
            "telephone_number": "877-467-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERSTONE OF ILLINOIS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "618-937-6483"
    },
    "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 Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.