Healthcare Provider Details

I. General information

NPI: 1417893959
Provider Name (Legal Business Name): ABC COUNSELING & FAMILY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 STATE ROUTE 116
METAMORA IL
61548-7734
US

IV. Provider business mailing address

614 STATE ROUTE 116
METAMORA IL
61548-7734
US

V. Phone/Fax

Practice location:
  • Phone: 309-451-9495
  • Fax:
Mailing address:
  • Phone: 309-451-9495
  • Fax:

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

VIII. Authorized Official

Name: LAURA MARIE JENNINGS-MITCHELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 309-451-9495