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General NPI Number Information
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NPI Number | 1457690216
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Entity Type | Organization
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Legal Business Name | ABBCON COUNSELING, INC.
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Dates
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Enumeration Date | 02/13/2013
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Last Update Date | 02/17/2019
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Provider Practice Location Address
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Address Line | 603 MONROE AVE
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City | CHARLESTON
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State | IL
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Zip | 61920-2034
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Country | US
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Telephone | 217-345-3156
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Fax | 217-345-3157
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Provider Business Mailing Address
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Address Line | 603 MONROE AVE
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City | CHARLESTON
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State | IL
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Zip | 61920-2034
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Country | US
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Telephone | 217-345-3156
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Fax | 217-345-3157
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | ASHLEY A. EPPERSON
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Credential | BS, CADC
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Telephone | 217-345-3156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | A-6036-0001-A
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License Number State | IL
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