South Eastern Illinois Counseling Center Inc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SOUTH EASTERN ILLINOIS COUNSELING CENTER INC

Practice address

254 S 5TH St
Albion, IL 62806-1121

Phone

(618) 445-3559

Fax

(618) 445-3935

NPI assigned

Feb 4, 2008

Last updated

Sep 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Glenn Jackson, M. DIV. LSW, LCPCNPI 1568833283

Title

Executive Director

Phone

(618) 395-4309

Specialties & licenses 5

Addresses

Other names 1

• EDWARDS FAMILY COUNSELING CENTER Other name

Practitioners 1

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.

• Glenn Jackson, LSW, LCPC, CMH

  • Mental Health Counselor
  • Olney, IL
  • NPI 1568833283
  Authorized official Same address or phone

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1982882866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX M",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624500913",
            "telephone_number": "618-395-4306",
            "fax_number": "618-395-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 S 5TH ST",
            "city": "ALBION",
            "state": "IL",
            "postal_code": "628061121",
            "telephone_number": "618-445-3559",
            "fax_number": "618-445-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH EASTERN ILLINOIS COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-395-4309",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M. DIV. LSW, LCPC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EDWARDS FAMILY COUNSELING CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mahayla Seaton, RN
• Vickie Diane Short, RN
• Southern Illinois Primary Care Associates, P.C.
• Speir Chiropractic, P.C.
• Caryl Pacubas Speir, P.T.
• Lawrence E Speir Jr., D.C.
• Tanea St Ledger, DPT

• Professional Counselor in Albion, IL
• Providers in Albion, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.