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General NPI Number Information
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NPI Number | 1811788797
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Entity Type | Organization
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Legal Business Name | QC PSYCH TESTING, PLLC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1001 E 7TH ST
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City | COAL VALLEY
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State | IL
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Zip | 61240-9150
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Country | US
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Telephone | 254-258-3542
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 74
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City | COAL VALLEY
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State | IL
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Zip | 61240-0074
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Country | US
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Telephone | 309-340-4496
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Fax | 309-606-4399
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Authorized Official
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Title or Position | CEO
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Name | BRANDON KUTMAS
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Credential | MS
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Telephone | 254-258-3542
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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 |
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License Number State |
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