Healthcare Provider Details

I. General information

NPI: 1285523514
Provider Name (Legal Business Name): PRIORITY MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 S PARK AVE
CHATHAM IL
62629-9759
US

IV. Provider business mailing address

328 S PARK AVE
CHATHAM IL
62629-9759
US

V. Phone/Fax

Practice location:
  • Phone: 217-220-4423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: NOEL NIGHTINGALE-FOLLIS
Title or Position: LCPC
Credential: LCPC
Phone: 217-220-4423