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PERRY COUNTY COUNSELING CENTER INC

Professional

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Contact Information

PERRY COUNTY COUNSELING CENTER INC
8271 E JACKSON STREET RD
DU QUOIN, IL  62832-3811
 Phone: 618-542-6722
 Fax: 618-542-6623
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Professional

 101YP2500X
 

Addiction (Substance Use Disorder)

 101YA0400X
 

Clinical

 1041C0700X 80 Licensed Clinical Social Worker
 

Prescribing (Medical)

 103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PERRY COUNTY COUNSELING CENTER INC

NPI Number 1851533996
LBN Legal business name PERRY COUNTY COUNSELING CENTER INC
Authorized official JOHN VENSKUS - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/06/2009
Last updated 04/06/2009 - About 17 years ago
Identifiers
License # 036077893
IL License # 149008165
IL License # 149010561
IL License # 149012186
IL License # 180003682
IL License # 180004129
IL License # 180004366
IL Medicaid 012300790
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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