Organization
C.R. BOOKER MEDIATION & COUNSELING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDYCE BOOKER (OWNER/THERAPIST)
(217) 552-4040
Entity
Organization
Contact information
Practice address
701 DEVONSHIRE DR, C-35, CHAMPAIGN, IL 61820-7337
(217) 552-4040
(217) 398-0413
Mailing address
606 KREBS DR, CHAMPAIGN, IL 61822-1105
(217) 552-4040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.017310
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295107787
NPI
IL
Enumeration date
10/07/2017
Last updated
10/09/2017
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