MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS (NPI# 1457505125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457505125 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS |
| Other Organization Name | MEMORIAL BEHAVIORAL HEALTH - SPRINGFIELD CHILDREN'S CENTER |
| Practice Address |
5220 S 6th Street Rd Suite 2400 Springfield IL 62703-5735 |
| Practice Telephone | 2177577700 |
| Practice Fax Number | 2177577799 |
| Mailing Telephone | 2177577700 |
| Mailing Fax Number | 2177577799 |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2016-03-18 |
| 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 | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Memorial Behavioral Health - Springfield Children's Center | 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 |
| 1013401322 | Mental Health Centers of Central Illinois | Clinic/Center | 340 W State St, Jacksonville, IL 62650-2061 | 2018-06-20 |
| 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 |
| Street Address |
5220 S 6TH STREET RD SUITE 2400 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62703-5735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336168269 | Hetal A Shah | Physical Therapist | 5220 S 6th Street Rd, Suite 1500, Springfield, IL 62703-5735 | 2006-07-19 |
| 1376093740 | Stephanie Nicole Fahey | Speech-Language Pathologist | 5220 S 6th Street Rd, Suite 1700 (noll Medical Pavillion, The Autism Clinic), Springfield, IL 62703-5735 | 2016-10-10 |
| 1285096560 | Meika Valerio | Behavioral Analyst | 5220 S 6th Street Rd, Suite 1700, Springfield, IL 62703-5735 | 2016-03-24 |
| 1770941957 | Katherine Docter | Behavioral Analyst | 5220 S 6th Street Rd, Springfield, IL 62703-5735 | 2016-02-03 |
| 1619332541 | Angela Westwood | Speech-Language Pathologist | 5220 S 6th Street Rd, Ste. 1700, Springfield, IL 62703-5735 | 2015-12-18 |
| 1962877571 | Anne Marie Wingbermuehle | Behavioral Analyst | 5220 S 6th Street Rd, Suite 1700, Springfield, IL 62703-5735 | 2015-12-08 |
| 1528432119 | The Hope School Dba The Autism Clinic | Counselor | 5220 S 6th Street Rd, Suite 1700, Springfield, IL 62703-5735 | 2015-11-19 |
| 1518343722 | Board of Trustees of Southern Illinois University | Clinic/Center | 5220 S 6th Street Rd, Suite 1500, Springfield, IL 62703-5735 | 2015-08-11 |
| 1457774416 | Brianne Satorius | Counselor | 5220 S 6th Street Rd, Suite 2400, Springfield, IL 62703-5735 | 2014-01-28 |
| 1114358199 | Jamie Lee Blakeman | Counselor | 5220 S 6th Street Rd, Suite 2400, Springfield, IL 62703-5735 | 2013-12-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790260917 | Jessica Lynne Zeeck | Behavior Technician | 5220 6th Street Frontage Road, E Suite 1700, Springfield, IL 62703 | 2018-10-03 |
| 1215415799 | Bree Schmulbach | Nurse Practitioner | Bsb Room 20, Springfield, IL 62703 | 2018-08-06 |
| 1144712100 | Fresenius Medical Care Springfield East, LLC | Clinic/Center | 140 S. Martin Luther King Jr. Drive, Springfield, IL 62703 | 2018-06-05 |
| 1558889170 | Ji Woung Choi | Dentist | 687 E Linton Ave., Springfield, IL 62703 | 2017-09-04 |
| 1477006161 | Encompass Home Health of The Midwest,llc | Home Health | 2970 Baker Dr, Springfield, IL 62703 | 2016-07-28 |
| 1851706824 | Terah Louise Holland | Obstetrics & Gynecology | 1100 E Lincolnshire Blvd Ste 200, Springfield, IL 62703 | 2014-06-27 |
| 1578993101 | Corey Moore | Behavioral Analyst | 5520 South 6th Street Road, Suite 1700, Springfield, IL 62703 | 2013-11-18 |
| 1134463052 | The Center for Youth and Family Solutions Inc. | Voluntary or Charitable | 614 North Sixth Street, Springfield, IL 62703 | 2012-11-15 |
| 1447519111 | Tenshi Furumi | Specialist/Technologist | One University Plaza, Univ. of Illinois-springfield, Ms Rec 2004, Springfield, IL 62703 | 2012-05-15 |
| 1447558390 | Shalini Mulkanoor | Family Medicine | 1100 E. Lincolnshire Blvd., Suite 200, Springfield, IL 62703 | 2011-03-02 |
| Find all providers in zip 62703 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114496916 | Transformations Therapy Center LLC | Clinic/Center | 110 Hillside Ave Ste 301, Springfield, NJ 07081-3007 | 2018-11-21 |
| 1851860209 | Preferred Family Healthcare, Inc | Clinic/Center | 3300 S National Ave Ste 500, Springfield, MO 65807-7343 | 2018-11-15 |
| 1982129722 | Solid Ground Counseling Services, LLC | Clinic/Center | 2515 W Allen Dr, Springfield, MO 65810-1300 | 2017-08-12 |
| 1568814390 | Self | Clinic/Center | 19 Merrick Ave Apt 1, Springfield, MA 01109-4324 | 2016-07-05 |
| 1538767090 | Camelot Care Centers, LLC | Clinic/Center | 2144 S Macarthur Blvd, Springfield, IL 62704-4502 | 2020-10-15 |
| 1609483049 | G Street Integrated Health | Clinic/Center | 1435 G St, Springfield, OR 97477-4113 | 2020-09-29 |
| 1225463136 | Colby Wang, Md, LLC | Clinic/Center | 636 W Republic Rd, B-112, Springfield, MO 65807-5818 | 2013-09-10 |
| 1174868442 | Ct- Family Care Services, LLC | Clinic/Center | 155 Maple St, Unit 204, Springfield, MA 01105-2649 | 2012-11-28 |
| 1922253947 | The Children's Center - Medical Services | Clinic/Center | 5220 S 6th Street Rd, Suite 2200, Springfield, IL 62703-5735 | 2008-11-18 |
| 1073706602 | Zoe Alison Burch | Clinic/Center | 15 E Pleasant St, Springfield, OH 45506-2201 | 2007-08-27 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62703 |
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.