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General NPI Number Information
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NPI Number | 1861119026
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Entity Type | Organization
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Legal Business Name | MINDFUL PERSPECTIVES
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 3835 E LAKE CTR
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City | QUINCY
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State | IL
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Zip | 62305-5847
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Country | US
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Telephone | 217-617-2475
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Fax |
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Provider Business Mailing Address
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Address Line | 727 RIM RD
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City | QUINCY
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State | IL
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Zip | 62305-8040
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Country | US
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Telephone | 217-617-2475
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | CRISTINA SUE CARGILL
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Credential | MS ED,LCPC
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Telephone | 217-617-2475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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