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General NPI Number Information
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NPI Number | 1558730713
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Entity Type | Organization
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Legal Business Name | MELISSA HILDEBRAND COUNSELING SERVICES
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 126 N 30TH ST SUITE 203
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City | QUINCY
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State | IL
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Zip | 62301-3719
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Country | US
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Telephone | 217-577-9100
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Fax | 217-666-4077
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Provider Business Mailing Address
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Address Line | 126 N 30TH ST SUITE 203
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City | QUINCY
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State | IL
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Zip | 62301-3719
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Country | US
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Telephone | 217-577-9100
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Fax | 217-666-4077
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. MELISSA ANN HILDEBRAND
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Credential | LCPC
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Telephone | 217-577-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 180007558
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License Number State | IL
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