Organization
LIVING HOPE COUNSELING CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARA RAE BAINUM PSY.D. (PRESIDENT & OWNER)
(217) 228-1887
Entity
Organization
Contact information
Practice address
535 MAINE ST, SUITE 13, QUINCY, IL 62301-3950
(217) 228-1887
(217) 228-1884
Mailing address
535 MAINE ST, SUITE 13, QUINCY, IL 62301-3950
(217) 228-1887
(217) 228-1884
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2006016141
MO
103TC0700X
Clinical Psychologist
Primary
071-006947
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427042076
INDIVIDUAL NPI #
—
05
—
491638904
—
MO
Enumeration date
02/27/2007
Last updated
08/11/2008
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