Healthcare Provider Details

I. General information

NPI: 1427853613
Provider Name (Legal Business Name): STORYTELLER'S COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 18TH ST
CHARLESTON IL
61920-2940
US

IV. Provider business mailing address

739 POLK AVE
CHARLESTON IL
61920-2832
US

V. Phone/Fax

Practice location:
  • Phone: 217-579-0102
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEFANI ANDERSON
Title or Position: OWNER/THERAPIST
Credential: LCPC
Phone: 217-579-0102