Organization
AVERAGE JOE PSYCHIATRIC SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL T FOUTCH APRN, PMHNP-BC (CEO)
(217) 714-1006
Entity
Organization
Contact information
Practice address
220 RED BUD DR, MAHOMET, IL 61853-9604
(217) 714-1006
Mailing address
220 RED BUD DR, MAHOMET, IL 61853-9604
(217) 714-1006
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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