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Organization
PERRY COUNTY COUNSELING CENTER INC
Active
Organization
PERRY COUNTY COUNSELING CENTER INC
Active
Other names
Southern Illinois Behavioral Services
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R VENSKUS (EXECUTIVE DIRECTOR)
(618) 542-4357
Entity
Organization
Contact information
Practice address
1016 S MADISON ST, SUITE A, DU QUOIN, IL 62832-2442
(618) 542-4357
(618) 542-3442
Mailing address
1016 S MADISON ST, SUITE A, DU QUOIN, IL 62832-2442
(618) 542-4357
(618) 542-3442
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/04/2006
Last updated
03/04/2021
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