Eric Eblin, MSW QMHP – Mental Health Counselor

Key facts

NPI: 1982255220
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
Practice address: 406 E Vine St
Vienna, IL 62995-1612
Phone: (618) 658-3079
Fax: (618) 658-2759
NPI assigned: Sep 27, 2019
Sex: Male
Sole proprietor: No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Arrowleaf Mental Health Clinic/Center (Including Community Mental Health Center) · Vienna, IL · NPI 1114387701

NPD (past)
Arrowleaf Mental Health Clinic/Center (Including Community Mental Health Center) · Vienna, IL · NPI 1528215290

NPD (past) MENTAL HEALTH

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Arrowleaf	Mental Health	Past since Sep 29, 2019	Accepting new patients
Arrowleaf		Past since Sep 29, 2019	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X			Yes

Addresses

Primary practice location

406 E Vine St
Vienna, IL 62995-1612

Mailing address

406 E Vine St
Vienna, IL 62995-1612
Phone (618) 658-3079

Other providers in Vienna, IL

All providers in Vienna, IL · Mental Health Counselor in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.