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General NPI Number Information
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NPI Number | 1902042369
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Entity Type | Organization
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Legal Business Name | EAST CENTRAL ILLINOIS HUMANISTICS, INC.
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 500 E. FAIRCHILD ST. SUITE A
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City | DANVILLE
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State | IL
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Zip | 61832-3117
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Country | US
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Telephone | 217-709-0282
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Fax | 217-709-0283
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Provider Business Mailing Address
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Address Line | 500 E. FAIRCHILD ST. SUITE A
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City | DANVILLE
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State | IL
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Zip | 61832-3117
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Country | US
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Telephone | 217-709-0282
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Fax | 217-709-0283
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICKEY WILLIAMS
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Credential | MS, QMHP, LPC
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Telephone | 217-474-3548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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