Healthcare Provider Details

I. General information

NPI: 1679488001
Provider Name (Legal Business Name): T SQUARE UNLIMITED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 W VIRGINIA AVE
EFFINGHAM IL
62401-2259
US

IV. Provider business mailing address

423 W VIRGINIA AVE
EFFINGHAM IL
62401-2259
US

V. Phone/Fax

Practice location:
  • Phone: 217-821-7513
  • Fax: 217-500-7757
Mailing address:
  • Phone:
  • Fax: 217-500-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: THERESA LOY
Title or Position: OWNER/PROVIDER
Credential: LOY
Phone: 217-821-7513