Healthcare Provider Details

I. General information

NPI: 1144593088
Provider Name (Legal Business Name): THE CENTER FOR YOUTH AND FAMILY SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 S MORRIS AVE
BLOOMINGTON IL
61701
US

IV. Provider business mailing address

502 S MORRIS AVE
BLOOMINGTON IL
61701-4884
US

V. Phone/Fax

Practice location:
  • Phone: 309-820-7616
  • Fax: 309-820-7657
Mailing address:
  • Phone: 309-820-7616
  • Fax: 309-820-7657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. STEPHANIE BARISCH
Title or Position: DIRECTOR OF THERAPEUTIC SERVICES
Credential: LCPC
Phone: 309-323-6600