SOUTHERN ILLINOIS REGIONAL SOCIAL SERVICES (NPI# 1932251758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932251758 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ILLINOIS REGIONAL SOCIAL SERVICES |
| Other Organization Name | JACKSON COUNTY COMMUNITY MENTAL HEALTH |
| Practice Address |
604 E College St Carbondale IL 62901-3309 |
| Mailing Address |
604 East College St Carbondale IL 62901-3309 |
| Practice Telephone | 6184576703 |
| Practice Fax Number | 6184578377 |
| Mailing Telephone | 6184576703 |
| Mailing Fax Number | 6184578377 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2010-09-15 |
| Authorized Official Name | MS. KAREN S FREITAG (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6184576703 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHERN ILLINOIS REGIONAL SOCIAL SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | A-0243-0001-A | IL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 002 | 05 |
| Other Name | Type Code |
|---|---|
| Jackson County Community Mental Health | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205074630 | Southern Illinois Regional Social Services | Community/Behavioral Health | 250 S Lewis Ln, Carbondale, IL 62901-3409 | 2009-01-22 |
| 1265679369 | Southern Illinois Regional Social Services | Community/Behavioral Health | 608 W Main St, Carbondale, IL 62901-2604 | 2009-01-12 |
| Street Address |
604 E COLLEGE ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-3309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932475506 | Southern Il Regional Social Services | Community/Behavioral Health | 604 E College St, Carbondale, IL 62901-3309 | 2012-03-28 |
| 1174897433 | The H Group Bbt, Inc | Community/Behavioral Health | 604 E College St, Carbondale, IL 62901-3309 | 2012-03-05 |
| 1326326877 | Daniel Wynn Balchen | Case Manager/Care Coordinator | 604 E College St, Carbondale, IL 62901-3309 | 2011-08-02 |
| 1669768446 | Geri L Tucker | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2011-06-21 |
| 1366737967 | Verletta Saxon | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2011-06-13 |
| 1073808796 | Tamara Marie George | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2011-06-10 |
| 1366745598 | Susan L Irwin | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2010-12-09 |
| 1144522889 | Rachelle Erin Ridgeway | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2010-12-01 |
| 1558692285 | Michelle Lynn Gibbs | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2010-01-20 |
| 1619103488 | Marissa Mckee | Counselor | 604 E College St, Carbondale, IL 62901-3309 | 2009-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194212282 | Bright Beginnings Therapeutic Services, LLC | Community/Behavioral Health | 41 N Main St Ste 310, Carbondale, PA 18407-2381 | 2018-04-16 |
| 1235504184 | Ascendigo Autism Services, Inc. | Community/Behavioral Health | 818 Industry Way, Carbondale, CO 81623-2508 | 2015-12-03 |
| 1326420068 | Hope Springs Counseling | Community/Behavioral Health | 1418 Country Road 107, Carbondale, CO 81623 | 2015-06-18 |
| 1740521285 | Southern Illinois Center for Art & Play Therapy LLC | Community/Behavioral Health | 105 N Emerald Ln, Suite C, Carbondale, IL 62901-2168 | 2013-03-08 |
| 1316282130 | Centerstone of Illinois, Inc | Community/Behavioral Health | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2012-12-05 |
| 1164726261 | Garfield Day Treatment Porgram | Community/Behavioral Health | 520 S 3rd St, Suite 24, Carbondale, CO 81623-2059 | 2011-01-04 |
| 1205074630 | Southern Illinois Regional Social Services | Community/Behavioral Health | 250 S Lewis Ln, Carbondale, IL 62901-3409 | 2009-01-22 |
| 1083851182 | Southern Il Regional Social Services | Community/Behavioral Health | 602 E College St, Carbondale, IL 62901-3309 | 2009-01-12 |
| 1891932992 | Southern Illinois Regional Social Service | Community/Behavioral Health | 212 S Lake Heights Ave, Carbondale, IL 62901-3463 | 2009-01-12 |
| 1235675984 | Ascendigo Autism Services, Inc. | Community/Behavioral Health | 818 Industry Way, Carbondale, CO 81623-2508 | 2017-01-18 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
Please comment or provide details below to improve the information on SOUTHERN ILLINOIS REGIONAL SOCIAL SERVICES.
| 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.