Organization
THE EASE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN S ENDICOTT-PLOG LCSW (CLINICAL DIRECTOR / SOLE PROPRIETOR)
(618) 233-3273
Entity
Organization
Contact information
Practice address
2900 FRANK SCOTT PKWY W STE 956, BELLEVILLE, IL 62223-5000
(618) 233-3273
(618) 234-7233
Mailing address
2900 FRANK SCOTT PKWY W STE 956, BELLEVILLE, IL 62223-5000
(618) 233-3273
(618) 234-7233
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149.008683
IL
Other
Enumeration date
06/05/2013
Last updated
06/05/2013
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