COLES COUNTY MENTAL HEALTH ASSOCIATION, INC. (NPI# 1053763250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053763250 |
| Entity Type | Organization |
| Organization Name | COLES COUNTY MENTAL HEALTH ASSOCIATION, INC. |
| Other Organization Name | LIFELINKS MENTAL HEALTH |
| Practice Address |
626 W Lincoln Ave Charleston IL 61920-2444 |
| Mailing Address |
750 Broadway Ave E Mattoon IL 61938-4610 |
| Practice Telephone | 2172385700 |
| Mailing Telephone | 2172385700 |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2018-04-27 |
| Authorized Official Name | ANGIE SOWERS (ACCESS CENTER COORDINATOR) |
| Authorized Official Telephone | 2172385700 |
| Authorized Official Credential | B.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| LifeLinks Mental Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568900454 | Coles County Mental Health Association, Inc. | Community/Behavioral Health | 302 N Mill St, Greenup, IL 62428 | 2017-02-10 |
| 1083892327 | Coles County Mental Health Association, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1305 Wabash Ave, Mattoon, IL 61938-4019 | 2008-02-08 |
| 1548448913 | Coles County Mental Health Association, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1504 20th St, Charleston, IL 61920-3615 | 2008-02-07 |
| 1164600979 | Coles County Mental Health Association, Inc. | Community Based Residential Treatment Facility, Mental Illness | 415 18th St, Charleston, IL 61920-2399 | 2008-02-04 |
| 1942203914 | Coles County Mental Health Association, Inc. | Community/Behavioral Health | 750 Broadway Ave E, Mattoon, IL 61938-4610 | 2005-05-24 |
| 1669084877 | Coles County Mental Health Association, Inc. | Clinic/Center | 1701 S Prospect Ave Ste 205, Champaign, IL 61820-7054 | 2020-08-19 |
| 1487165577 | Coles County Mental Health Association, Inc. | Community/Behavioral Health | 1275 Hawthorn Rd, Salem, IL 62881-1028 | 2017-10-17 |
| 1154788545 | Coles County Mental Health Association, Inc. | Community/Behavioral Health | 700 Broadway Ave E, Mattoon, IL 61938-4671 | 2016-01-15 |
| 1831213669 | Coles County Mental Health Association, Inc. | Private Vehicle | 750 Broadway Ave E, Mattoon, IL 61938-4610 | 2007-03-19 |
| Street Address |
626 W LINCOLN AVE |
| City | CHARLESTON |
| State | IL |
| Zip Code | 61920-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801232954 | Danelle Lyn Jackson | Nurse Practitioner | 626 W Lincoln Ave, Charleston, IL 61920-2444 | 2013-05-16 |
| 1487070835 | Southern Illinois Healthcare Foundation, Inc. | Dentist | 626 W Lincoln Ave, Charleston, IL 61920-2444 | 2014-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124643879 | Jenna Kay Mortensen | Speech-Language Pathologist | 2086 7th Street, Charleston, IL 61920 | 2020-06-09 |
| 1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
| 1679066773 | Jennifer Hess | Specialist/Technologist | 2506 Lantz Building, Charleston, IL 61920 | 2018-06-13 |
| 1134647969 | Nichole C Ogilvie | Student in an Organized Health Care Education/Training Program | 917 4th Street Apt 19, Charleston, IL 61920 | 2017-08-31 |
| 1467970319 | Marcus Roach | Physical Therapy Assistant | 912 Oakcrest Dr. Apt D, Charleston, IL 61920 | 2017-08-30 |
| 1114478500 | 5 Guys Rx II LLC | Pharmacy | 1 W Lincoln Ave, Charleston, IL 61920 | 2016-10-20 |
| 1649723206 | Bright Minds Educational Program Inc | Developmental Therapist | 7704 Deerpath Road, Charleston, IL 61920 | 2016-08-01 |
| 1760843379 | Lisa Price | Nurse Practitioner | 2040 Lincoln Ave, Suite 100, Charleston, IL 61920 | 2016-03-09 |
| 1104243385 | Nathan David Schwartzkopf | Specialist/Technologist | 1340 A Street, Charleston, IL 61920 | 2014-03-25 |
| 1558694349 | Emily Schilling | Specialist/Technologist | 2350 Harrison Avenue, Charelston, IL 61920 | 2009-09-10 |
| Find all providers in zip 61920 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1598305138 | Kg Psychotherapy LLC | Clinic/Center | 711a Saint Andrews Blvd Ste A, Charleston, SC 29407-7140 | 2020-01-12 |
| 1407499072 | Klw Counseling & Consulting, LLC | Clinic/Center | 125 Wappoo Creek Dr Ste G, Charleston, SC 29412-2162 | 2019-10-25 |
| 1679060420 | Partnership of African American Churches Inc. | Clinic/Center | 1514 Kanawha Blvd W, Charleston, WV 25387-2533 | 2018-04-17 |
| 1386851509 | Kanawha Valley Center Inc | Clinic/Center | 200 Bradford Street, Charleston, WV 25301-5301 | 2007-05-17 |
| 1659382703 | Highland Behavioral Health Services Inc | Clinic/Center | 511 Morris Street, Charleston, WV 25301 | 2006-08-11 |
| 1740291897 | Highland Behavioral Health Services Inc | Clinic/Center | 5600 Maccorkle Ave Se, Suite 6, Charleston, WV 25304 | 2006-08-11 |
| 1225645005 | Mikayla Harper, LLC | Clinic/Center | 452 Folly Rd, Charleston, SC 29412-2641 | 2020-09-25 |
| 1154840841 | Mbh Physician Group -wv Pllc | Clinic/Center | 1418 Maccorkle Ave Sw, Charleston, WV 25303-1342 | 2017-09-13 |
| 1760896740 | Highland Behavioral Health Services, Inc | Clinic/Center | 2500 Cherokee Avenue, Charleston, WV 25304 | 2014-06-17 |
| 1164639373 | Kanawha Valley Center Inc | Clinic/Center | 200 Bradford Street, Charleston, WV 25301-5301 | 2007-05-17 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 61920 |
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| 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.