Organization
INGRAM COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA M INGRAM (LCPC/COUNSELOR)
(314) 722-8281
Entity
Organization
Contact information
Practice address
1161 FORTUNE BLVD STE 400, SHILOH, IL 62269-7385
(314) 722-8281
(618) 206-8476
Mailing address
1161 FORTUNE BLVD STE 400, SHILOH, IL 62269-7385
(314) 722-8281
(618) 206-8476
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
180.010041
IL
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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