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General NPI Number Information
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NPI Number | 1992867667
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Entity Type | Organization
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Legal Business Name | SPRINGFIELD FAMILY COUNSELING CENTER
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 07/27/2008
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Provider Practice Location Address
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Address Line | 1700 S SPRING ST SUITE A1
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City | SPRINGFIELD
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State | IL
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Zip | 62704-3961
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Country | US
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Telephone | 217-494-3727
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 S SPRING ST SUITE A1
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City | SPRINGFIELD
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State | IL
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Zip | 62704-3961
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Country | US
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Telephone | 217-494-3727
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MR. GLENN M. CURRY
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Credential | LCSW
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Telephone | 217-494-3727
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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 | 150-10021
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License Number State | IL
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