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Organization
SOUTH EASTERN ILLINOIS COUNSELING CENTER INC
Active
Organization
SOUTH EASTERN ILLINOIS COUNSELING CENTER INC
Active
Other names
EDWARDS FAMILY COUNSELING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN JACKSON M. DIV. LSW, LCPC (EXECUTIVE DIRECTOR)
(618) 395-4309
Entity
Organization
Contact information
Practice address
254 S 5TH ST, ALBION, IL 62806-1121
(618) 445-3559
(618) 445-3935
Mailing address
PO BOX M, OLNEY, IL 62450-0913
(618) 395-4306
(618) 395-4507
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
02/04/2008
Last updated
09/15/2011
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