Organization
CISCO COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WASHINGTON DIXON CISCO MR (CEO)
(618) 267-0305
Entity
Organization
Contact information
Practice address
1504 S POPLAR ST, CENTRALIA, IL 62801-5172
(618) 267-0305
Mailing address
1504 S POPLAR ST, CENTRALIA, IL 62801-5172
(618) 267-0305
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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