Healthcare Provider Details

I. General information

NPI: 1629980974
Provider Name (Legal Business Name): KAY BLANKENSHIP COUNSELING & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 S MAIN ST STE 108
EUREKA IL
61530-1161
US

IV. Provider business mailing address

108 S MAIN ST STE 108
EUREKA IL
61530-1161
US

V. Phone/Fax

Practice location:
  • Phone: 309-964-4190
  • Fax:
Mailing address:
  • Phone: 309-964-4190
  • 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: KAY ELIZABETH BLANKENSHIP
Title or Position: PROFESSIONAL COUNSELOR
Credential: LCPC
Phone: 309-964-4190