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General NPI Number Information
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NPI Number | 1982521035
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Entity Type | Organization
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Legal Business Name | THE LITTLE RESOURCE CENTER CARBONDALE
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 608 EASTGATE ST
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City | CARBONDALE
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State | IL
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Zip | 62901-3304
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Country | US
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Telephone | 618-605-9046
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Fax |
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Provider Business Mailing Address
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Address Line | 608 EASTGATE ST
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City | CARBONDALE
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State | IL
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Zip | 62901-3304
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Country | US
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Telephone | 618-605-9046
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Fax |
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Authorized Official
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Title or Position | CEO/FULL SPECTRUM DOULA
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Name | CHASTITY MAYS
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Credential | CD(SOKANA)
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Telephone | 618-525-2676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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