South Eastern Illinois Counseling Center INC

NPI #1457539330 in Flora, Illinois

Provider Information

NPI Number: 1457539330
Entity Type: Organization
Organization Name: South Eastern Illinois Counseling Center INC
Primary Specialty: Counselor - Professional
Enumeration Date: Feb 4, 2008
Last Updated: Sep 15, 2011

Practice Location

Address: 901 W 3RD ST
City: Flora
State: Illinois
ZIP Code: 62839-1287
Phone: (618) 662-2871

Authorized Official

Name: MR. GLENN JACKSON, M. DIV. LSW, LCPC
Title: EXECUTIVE DIRECTOR
Phone: (618) 395-4309

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X
Counselor	101Y00000X
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X	Primary

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