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General NPI Number Information
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NPI Number | 1912224783
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Entity Type | Organization
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Legal Business Name | J&C PSYCHOTHERAPY SERVICES INC
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 301 W. GREEN STREET
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City | URBANA
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State | IL
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Zip | 61801-3200
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Country | US
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Telephone | 217-384-7922
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Fax | 217-328-6765
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Provider Business Mailing Address
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Address Line | 301 W. GREEN STREET
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City | URBANA
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State | IL
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Zip | 61801-3200
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Country | US
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Telephone | 217-384-7922
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Fax | 217-328-6765
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MR. RONALD STEVEN ROTHSCHILD
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Credential | L.C.S.W.
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Telephone | 217-384-7922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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