Organization
ELLIOTT COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA JO ELLIOTT (MANAGER/OWNER)
(309) 212-3606
Entity
Organization
Contact information
Practice address
706 OGLESBY AVE STE 300, NORMAL, IL 61761-4616
(309) 212-3606
(312) 789-4373
Mailing address
1310 E GROVE ST, BLOOMINGTON, IL 61701-4215
(309) 212-2496
(312) 789-4373
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
180004957
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/15/2010
Last updated
01/23/2023
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