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General NPI Number Information
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NPI Number | 1891960670
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Entity Type | Organization
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Legal Business Name | SOLID ROCK COUNSELING
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 100 W JEFFERSON ST
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City | OTTAWA
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State | IL
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Zip | 61350-5005
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Country | US
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Telephone | 815-712-2838
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Fax | 815-496-2929
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Provider Business Mailing Address
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Address Line | 100 W JEFFERSON ST
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City | OTTAWA
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State | IL
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Zip | 61350-5005
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Country | US
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Telephone | 815-712-2838
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Fax | 815-496-2929
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Authorized Official
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Title or Position | OWNER
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Name | MR. LEON MCCLIMANS
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Credential | LCPC
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Telephone | 815-712-2838
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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 | 180006544
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License Number State | IL
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