Organization
SOUTHERN ILLINOIS COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM JACKSON LCPC (OWNER)
(618) 924-5633
Entity
Organization
Contact information
Practice address
608 S FOREST AVE, CARBONDALE, IL 62901-2525
(618) 924-5633
Mailing address
608 S FOREST AVE, CARBONDALE, IL 62901-2525
(618) 924-5633
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/29/2025
Last updated
04/07/2026
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