MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS (NPI# 1013401322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013401322 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS |
| Other Organization Name | MEMORIAL BEHAVIORAL HEALTH - JACKSONVILLE |
| Practice Address |
340 W State St Jacksonville IL 62650-2061 |
| Mailing Address |
710 N 8th St Springfield IL 62702-6324 |
| Practice Telephone | 2172456126 |
| Practice Fax Number | 2172454296 |
| Mailing Telephone | 2172525110 |
| Mailing Fax Number | 2175251651 |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | ROBYN L LUKE (ADMINISTRATOR) |
| Authorized Official Telephone | 2175251064 |
| Is Organization Subpart | Y |
| Parent Organization Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Memorial Behavioral Health - Jacksonville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730554692 | Mental Health Centers of Central Illinois | Day Training, Developmentally Disabled Services | 760 S Postville Dr, Lincoln, IL 62656-2237 | 2015-12-03 |
| 1558910794 | Mental Health Centers of Central Illinois | Clinic/Center | 303 E Bidwell St, Taylorville, IL 62568-1363 | 2019-09-10 |
| 1295160323 | Mental Health Centers of Central Illinois | Clinic/Center | 515 N College St, Lincoln, IL 62656-1401 | 2013-09-09 |
| 1225361769 | Mental Health Centers of Central Illinois | Clinic/Center | 200 W Lake Dr, Building A, Springfield, IL 62703-4956 | 2009-09-16 |
| 1750614798 | Mental Health Centers of Central Illinois | Counselor | 901 N 1st St, Suite 225, Springfield, IL 62702-3759 | 2009-09-09 |
| 1023263043 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building C, Springfield, IL 62703-4956 | 2008-11-18 |
| 1932354958 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building D, Springfield, IL 62703-4956 | 2008-11-18 |
| 1841445863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building E, Springfield, IL 62703-4956 | 2008-11-18 |
| 1659525863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Buidling B, Springfield, IL 62703-4956 | 2008-11-14 |
| 1457505125 | Mental Health Centers of Central Illinois | Clinic/Center | 5220 S 6th Street Rd, Suite 2400, Springfield, IL 62703-5735 | 2008-11-07 |
| Street Address |
340 W STATE ST |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-2061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437128006 | Kathy Moore Dyson | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2006-03-16 |
| 1629694583 | Elizbeth Huss Secrist | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2020-06-17 |
| 1063058113 | Nora A Bishop | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2019-11-25 |
| 1538644646 | Misty Dawn Spencer | Social Worker | 340 W State St, Jacksonville, IL 62650-2061 | 2018-09-25 |
| 1699253815 | Teegan Rochelle Lund | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2018-07-31 |
| 1558736959 | Christina L. Meads | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2015-12-10 |
| 1164856407 | Yoli S Holmes | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2013-08-22 |
| 1649537747 | Betsy Van Brocklin | Social Worker | 340 W State St, Jacksonville, IL 62650-2061 | 2012-04-13 |
| 1972887156 | Debra K Webb | Social Worker | 340 W State St, Jacksonville, IL 62650-2061 | 2011-10-05 |
| 1225282999 | Mental Health Centers of Central Illinois | Clinic/Center | 340 W State St, Jacksonville, IL 62650 | 2008-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700333978 | Recovery Counseling and More Inc | Clinic/Center | 4570 Saint Johns Ave, Ste B, Jacksonville, FL 32210 | 2016-09-06 |
| 1750763942 | Jacksonville Treatment Center | Clinic/Center | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2015-06-24 |
| 1952484438 | Greenfield Center Inc | Clinic/Center | 4250 Lakeside Dr Ste 213, Jacksonville, FL 32210-3369 | 2006-10-20 |
| 1326674995 | Cass County Mental Health Assoc | Clinic/Center | 60 E Central Park Plz, Jacksonville, IL 62650-2071 | 2020-03-16 |
| 1568970663 | Gateway Foundation, Inc. | Clinic/Center | 1300 Lincoln Ave, Jacksonville, IL 62650-3112 | 2018-01-11 |
| 1942724885 | Gateway Clinic, LLC | Clinic/Center | 7999 Philips Hwy, Suite 305, Jacksonville, FL 32256 | 2017-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689273153 | Navis Health LLC | Clinic/Center | 2602 Rolling Acres Dr, Champaign, IL 61822-7240 | 2020-10-25 |
| 1164036661 | Existential Counselor Societ Ltd. | Clinic/Center | 1225 Richards St, Joliet, IL 60433-2745 | 2020-09-02 |
| 1457964934 | Rosecrance Inc | Clinic/Center | 15 N Galena Ave, Freeport, IL 61032-4348 | 2020-08-25 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1174148167 | Associates In Behavioral Health Care | Clinic/Center | 910 Lake St Ste 102, Roselle, IL 60172-3384 | 2020-06-15 |
| 1538784533 | Associates In Behavioral Health Care | Clinic/Center | 1375 E Schaumburg Rd Ste 120, Schaumburg, IL 60194-3643 | 2020-06-15 |
| 1265056964 | Gateway Foundation, Inc. | Clinic/Center | 3040 Finley Rd, Downers Grove, IL 60515-5713 | 2020-05-29 |
| 1922634021 | Lutheran Social Services of Illinois | Clinic/Center | 400 N Cherry St, Morrison, IL 61270-2605 | 2020-03-20 |
| 1144852260 | Vincent Wallace | Clinic/Center | 226 W Ontario St, Chicago, IL 60654-3619 | 2020-02-06 |
| 1093354037 | A Bridge Back, Inc. | Clinic/Center | 314 Mchenry Rd, Buffalo Grove, IL 60089-2428 | 2019-12-21 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
Please comment or provide details below to improve the information on MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.