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Organization

SOUTH EASTERN ILLINOIS COUNSELING CENTER INC

Active
Other names
JASPER 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
902 W JOURDAN ST, NEWTON, IL 62448-1062
(618) 783-8615
(618) 783-4174
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
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
02/04/2008
Last updated
07/23/2009
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