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Organization
OGBURN COUNSELING SERVICES, LLC
Active
Organization
OGBURN COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEIA A OGBURN LCSW (SOLE MEMBER)
(309) 682-3915
Entity
Organization
Contact information
Practice address
5113 N EXECUTIVE DR STE 101, PEORIA, IL 61614-4884
(309) 682-3915
(309) 679-0703
Mailing address
5113 N EXECUTIVE DR STE 101, PEORIA, IL 61614-4884
(309) 682-3915
(309) 679-0703
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-008753
IL
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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