MEDICARE: MARRIAGE AND FAMILY COUNSELING SERVICE OF R I CO

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
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1629292693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARRIAGE AND FAMILY COUNSELING SERVICE OF R I CO

Provider Business Mailing Address
First Line	:	1800 3RD AVE STE 512
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-8019
Country	:	US
Telephone Number	:	309-786-4491
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 3RD AVE
Second Line	:	SUITE 512
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-8026
Country	:	US
Telephone Number	:	309-786-4491
Fax Number	:	309-786-0205

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. WILLIAM J. HIEBERT
Credential	:	LMFT
Telephone Number	:	309-786-4491

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	01/19/2026

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