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General NPI Number Information
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NPI Number | 1497563993
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Entity Type | Organization
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Legal Business Name | CLS COUNSELING & CONSULTING, PLLC
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 08/23/2025
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Provider Practice Location Address
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Address Line | 1063 S STATE ROUTE 157 STE 2-128
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-3695
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Country | US
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Telephone | 618-515-5890
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Fax | 866-423-9057
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Provider Business Mailing Address
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Address Line | 1063 S STATE ROUTE 157 STE 2-128
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-3695
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Country | US
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Telephone | 618-515-5890
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Fax |
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Authorized Official
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Title or Position | FOUNDER & CEO
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Name | MS. CASSANDRA SISSOM
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Credential | LPC, LCPC
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Telephone | 618-515-5890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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