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Organization
EPHPHATHA CONSULTING SERVICES, INC.
Active
Organization
EPHPHATHA CONSULTING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENTON K JOHNSON II PHD (PRESIDENT)
(309) 558-9050
Entity
Organization
Contact information
Practice address
2424 40TH AVE, SUITE 5, MOLINE, IL 61265-7215
(309) 558-9050
Mailing address
2424 40TH AVE, SUITE 5, MOLINE, IL 61265-7215
(309) 558-9050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
001063
IA
101YM0800X
Mental Health Counselor
Primary
180006524
IL
101YP2500X
Professional Counselor
180006524
IL
Other
Enumeration date
08/05/2010
Last updated
11/30/2013
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