SOUTH EASTERN ILLINOIS COUNSELING CENTER INC (NPI# 1336137199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336137199 |
| Entity Type | Organization |
| Organization Name | SOUTH EASTERN ILLINOIS COUNSELING CENTER INC |
| Practice Address |
504 Micah Drive Drawer M Olney IL 62450 |
| Mailing Address |
Po Box M 504 Micah Drive Olney IL 62450-0913 |
| Practice Telephone | 6183954306 |
| Practice Fax Number | 6183954507 |
| Mailing Telephone | 6183954306 |
| Mailing Fax Number | 6183954507 |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2016-05-05 |
| Authorized Official Name | MR. GLENN JACKSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6183954309 |
| Authorized Official Credential | M.DIV., LSW, LCP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 343700207 | 05 | |
| IL | 036037359 | 05 | |
| IL | 036072942 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700064268 | South Eastern Illinois Counseling Center Inc | Case Management | 204a W. Highland, Robinson, IL 62454 | 2008-02-07 |
| 1952589830 | South Eastern Illinois Counseling Center Inc | Clinic/Center | 407 N Basin Rd, Fairfield, IL 62837-9639 | 2008-02-04 |
| 1649458522 | South Eastern Illinois Counseling Center Inc | Case Management | 515 W Saint John St, Olney, IL 62450-1426 | 2008-02-04 |
| 1710165279 | South Eastern Illinois Counseling Center Inc | Clinic/Center | 504 Micah Drive, Olney, IL 62450-0913 | 2008-02-07 |
| 1982882866 | South Eastern Illinois Counseling Center Inc | Counselor | 254 S 5th St, Albion, IL 62806-1121 | 2008-02-04 |
| 1891973772 | South Eastern Illinois Counseling Center Inc | Clinic/Center | 204 W Highland Ave, Robinson, IL 62454-1710 | 2008-02-04 |
| 1245418128 | South Eastern Illinois Counseling Center Inc | Counselor | 902 W Jourdan St, Newton, IL 62448-1062 | 2008-02-04 |
| 1407034382 | South Eastern Illinois Counseling Center Inc | Clinic/Center | 602 E 5th St, Mount Carmel, IL 62863-2152 | 2008-02-04 |
| 1003094988 | South Eastern Illinois Counseling Center Inc | Case Management | 118 W North Ave, Flora, IL 62839-1612 | 2008-02-04 |
| 1235317116 | South Eastern Illinois Counseling Center Inc | Clinic/Center | 1501 Olive St, Lawrenceville, IL 62439-2269 | 2008-02-04 |
| Street Address |
504 MICAH DRIVE DRAWER M |
| City | OLNEY |
| State | IL |
| Zip Code | 62450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326200460 | Jason Potts | Counselor | 504 Micah Drive, Box Drawer M, Olney, IL 62450-0913 | 2008-06-30 |
| 1710165279 | South Eastern Illinois Counseling Center Inc | Clinic/Center | 504 Micah Drive, Olney, IL 62450-0913 | 2008-02-07 |
| 1366622128 | Renee Patterson | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2007-11-09 |
| 1780864546 | Melody Fore | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2007-11-09 |
| 1407044068 | Rebecca Wilborn-ready | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2007-10-09 |
| 1679761399 | David Judy | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450-0913 | 2007-10-09 |
| 1588852206 | Megan Eagleson | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450-0913 | 2007-10-09 |
| 1194913947 | Donna Greenwood | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2007-10-05 |
| 1922296771 | Mary Fletcher | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2007-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851530091 | Donna Harris | Counselor | 515 West St. John Street, Olney, IL 62450 | 2009-02-11 |
| 1942476908 | Christa Dawn Jennette | Private Vehicle | 1113 Keiffer Dr, Olney, IL 62450 | 2008-04-30 |
| 1942491162 | Marion County Horizon Center D/b/a Richland Manor | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1066 West Main St, Olney, IL 62450 | 2007-08-05 |
| 1811100407 | Advanced Open Mri, Inc. | Clinic/Center | 605 East Main Street, Olney, IL 62450 | 2007-05-08 |
| 1548489958 | Frank Edward Gruber | Dentist | 1108 N East St, Olney, IL 62450 | 2007-04-24 |
| 1508084591 | Melvin Borja Escalona | Physical Therapist | 800 East Locust St., Olney, IL 62450 | 2007-04-23 |
| 1881769826 | Jeffrey Alan Kocher | Chiropractor | 731 S West St, Olney, IL 62450 | 2006-11-22 |
| 1336211523 | Patricia Lynn Kessler Bookhout | Dentist | 1104 North East, Olney, IL 62450 | 2006-11-14 |
| 1639159015 | Bowers Drug Store Inc | Pharmacy | 205 E Main, Olney, IL 62450 | 2006-01-20 |
| 1932684313 | Kylie L Garbe | Nurse Practitioner | 1200 N East St, Olney, IL 62450 | 2018-10-01 |
| Find all providers in zip 62450 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093345993 | Crystal Gail Cook | Counselor | 35103 State Highway 79 S, Olney, TX 76374-2505 | 2020-01-19 |
| 1568829620 | Amy J. White, Lcpc & Associates PC | Counselor | 2931 Olney Sandy Spring Rd Ste F, Olney, MD 20832-1579 | 2016-01-20 |
| 1902223654 | Lydia Dickey | Counselor | 504 Micar Drive, Olney, IL 62450-4720 | 2014-03-19 |
| 1578012480 | Steven Powden | Counselor | 504 Micah Dr, Drawer M, Olney, IL 62450-4720 | 2016-10-04 |
| 1184071136 | Richland Family Counseling Ctrs Inc | Counselor | 504 Micah Dr, Drawer M, Olney, IL 62450-4720 | 2016-05-19 |
| 1568833283 | Glenn Jackson | Counselor | 504 Micah Dr, Drawer M, Olney, IL 62450-4720 | 2015-10-08 |
| 1619318623 | Ember Keller | Counselor | 504 Micah Dr, Drawer M, Olney, IL 62450-4720 | 2013-07-08 |
| 1679761399 | David Judy | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450-0913 | 2007-10-09 |
| 1922296771 | Mary Fletcher | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2007-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071932 | Euginia Ivanova | Counselor | 3410 W. Roosevelt Rd, Chicago, IL 60624 | 2020-10-19 |
| 1093322638 | New Horizon Mental and Behavioral Services | Counselor | 12052 S Lockwood Ave, Alsip, IL 60803-3165 | 2020-09-28 |
| 1780299818 | Sophia Bilikovsky | Counselor | 3025 Monterey Ln, Wadsworth, IL 60083-8924 | 2020-09-15 |
| 1497360697 | Cassandra Lynn Wegner | Counselor | 2529 Ravinia Ln, Woodridge, IL 60517-2241 | 2020-09-14 |
| 1831703131 | Colleen Mertens | Counselor | 100 Tower Dr Ste 236, Burr Ridge, IL 60527-5787 | 2020-09-03 |
| 1073127775 | Deborah Lynn Dettman | Counselor | 1209 W Sherwin Ave Apt 809, Chicago, IL 60626-2257 | 2020-09-01 |
| 1417574203 | Kathy O Valentin | Counselor | 1640 Pleasant Ln, Glenview, IL 60025-1847 | 2020-06-29 |
| 1669098844 | James Earl Brooks I | Counselor | 523 Clark St, South Beloit, IL 61080-1317 | 2020-06-23 |
| 1780200014 | Anchorpoint Adolescent Consultant Group Inc. | Counselor | 1246 N Yale Ave, Arlington Heights, IL 60004-4564 | 2020-06-23 |
| 1891311502 | Ashlie Jones | Counselor | 3226 Hoffman St, Plano, IL 60545-1992 | 2020-06-18 |
| Find all providers with the same taxonomy | ||||
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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.