Counseling Clinic LTD.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

COUNSELING CLINIC LTD.

Practice address

871 S Arbor Vitae Ste 3
Edwardsville, IL 62025-3400

Phone

(618) 659-9111

Fax

(618) 692-9111

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Jean Perry

Title

Office Manager

Phone

(618) 659-9111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ruth Cohen Kubicek, LCSW

  • Clinical Social Worker
  • Glen Carbon, IL
  • NPI 1922155886
  Medicare reassignment NPD

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1922287887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 S ARBOR VITAE SUITE 003",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253400",
            "telephone_number": "618-659-9111",
            "fax_number": "618-692-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 S ARBOR VITAE STE 3",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253400",
            "telephone_number": "618-659-9111",
            "fax_number": "618-692-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING CLINIC LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "618-659-9111"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Core Physical Medicine LLC
• Meredith Corr
• Brandy Corzine, PTA
• Mason T Cotterel, MAT, ATC
• Cailyn Capri Cottingham
• Megan M Cox, DNP, FNP
• Rochelle Lynn Cox, P.T.A.
• Landry Crabtree, NP
• Ariel R Crader
• Margaret Ann Crandall

• Clinical Social Worker in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Clinical Social Worker in Illinois

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