| Counseling Associates Of Southern Illinois | |
|
1669 Windham Way Suite B O Fallon IL 62269-3072 | |
| (618) 622-2579 | |
| (618) 624-8506 |
| Full Name | Counseling Associates Of Southern Illinois |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1669 Windham Way, O Fallon, Illinois |
| Authorized Official Name and Position | Sheri L Miller (CO OWNER) |
| Authorized Official Contact | 6186222579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling Associates Of Southern Illinois 1669 Windham Way Suite B O Fallon IL 62269-3072 Ph: (618) 622-2579 | Counseling Associates Of Southern Illinois 1669 Windham Way Suite B O Fallon IL 62269-3072 Ph: (618) 622-2579 |
| NPI Number | 1689706533 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 09/08/2015 |
| Medicare PECOS PAC ID | 6305945304 |
|---|---|
| Medicare Enrollment ID | O20070615000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689706533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Janice L Sheridan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841273018 PECOS PAC ID: 3870666969 Enrollment ID: I20080723000265 |
| Provider Name | Scott E Baer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639363229 PECOS PAC ID: 1153470166 Enrollment ID: I20090522000073 |
| Provider Name | Sheri L Miller |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1841256419 PECOS PAC ID: 3779682604 Enrollment ID: I20240312000089 |
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