Methodist

NPI #1811512411 in Peoria, Illinois

Provider Information

NPI Number: 1811512411
Entity Type: Organization
Organization Name: Methodist
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jun 10, 2020
Last Updated: Jun 10, 2020

Practice Location

Address: 221 NE GLEN OAK AVE
City: Peoria
State: Illinois
ZIP Code: 61636-0001
Phone: (309) 672-5604

Authorized Official

Name: MR. CHRISTOPHER LEGAN, LCPC
Title: PHP THERAPIST
Phone: (309) 672-5604

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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