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Organization
PREFERRED BEHAVIORAL HEALTH MSO, INC.
Active
Organization
PREFERRED BEHAVIORAL HEALTH MSO, INC.
Active
Other names
PREFERRED BEHAVIORAL HEALTH, ITIC SUPPORT SERVICES, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN W MORRIS (PRESIDENT)
(217) 242-7718
Entity
Organization
Contact information
Practice address
141 MARKET PL STE 100, FAIRVIEW HEIGHTS, IL 62208-2089
(618) 398-4226
(618) 398-1759
Mailing address
141 MARKET PL STE 100, FAIRVIEW HEIGHTS, IL 62208-2089
(618) 398-4226
(618) 398-1759
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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