=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295312106
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOILES COUNSELLING, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2021
-----------------------------------------------------
Last Update Date | 03/26/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 307 HENRY ST STE 407
-----------------------------------------------------
City | ALTON
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62002-6326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-567-3206
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 86 EASTMOOR DR
-----------------------------------------------------
City | WOOD RIVER
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62095-4017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-567-3206
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | APRIL FOILES
-----------------------------------------------------
Credential | LCPC
-----------------------------------------------------
Telephone | 618-567-3206
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 102L00000X
-----------------------------------------------------
Taxonomy Name | Psychoanalyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------