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General NPI Number Information
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NPI Number | 1154634632
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Entity Type | Organization
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Legal Business Name | A & M COUNSELING, PC
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 114 WHITELAW AVE
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City | WOOD RIVER
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State | IL
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Zip | 62095-1911
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Country | US
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Telephone | 618-251-4225
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Fax |
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Provider Business Mailing Address
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Address Line | 114 WHITELAW AVE
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City | WOOD RIVER
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State | IL
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Zip | 62095-1911
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Country | US
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Telephone | 618-251-4225
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | KAREN AUGUSTYN
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Credential | MA, LCPC, CADC
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Telephone | 618-251-4225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180006255
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License Number State | IL
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