Ingram Counseling Services, Llc | |
1161 Fortune Blvd Ste 400 Shiloh IL 62269-7385 | |
(314) 722-8281 | |
(618) 206-8476 |
Full Name | Ingram Counseling Services, Llc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 1161 Fortune Blvd Ste 400, Shiloh, Illinois |
Authorized Official Name and Position | Angela M Ingram (LCPC/COUNSELOR) |
Authorized Official Contact | 3147228281 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ingram Counseling Services, Llc 1161 Fortune Blvd Ste 400 Shiloh IL 62269-7385 Ph: (314) 722-8281 | Ingram Counseling Services, Llc 1161 Fortune Blvd Ste 400 Shiloh IL 62269-7385 Ph: (314) 722-8281 |
NPI Number | 1720569726 |
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Provider Enumeration Date | 08/27/2018 |
Last Update Date | 08/27/2018 |
Identifier | Type | State | Issuer |
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1720569726 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 180.010041 (Illinois) | Primary |
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