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NPI Code Detail

MEDICARE: A & M COUNSELING, PC

MEDICARE: A & M COUNSELING, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor180006255IL

General Provider Information

NPI Number : 1154634632
Entity Type Code : Organization
Provider Name (Legal Business Name) : A & M COUNSELING, PC
Provider Business Mailing Address
First Line : 114 WHITELAW AVE
Second Line :
City : WOOD RIVER
State : IL
Zip : 62095-1911
Country : US
Telephone Number : 618-251-4225
Fax Number :
Provider Business Practice Location Address
First Line : 114 WHITELAW AVE
Second Line :
City : WOOD RIVER
State : IL
Zip : 62095-1911
Country : US
Telephone Number : 618-251-4225
Fax Number :
Authorized Official
Title or Position : COUNSELOR
Name : KAREN AUGUSTYN
Credential : MA, LCPC, CADC
Telephone Number : 618-251-4225
Provider Enumeration Date : 07/26/2010
Last Update Date : 07/26/2010

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