| Kevin Elliott Counseling, Inc. | |
|
309 W Clark St Champaign IL 61820-4637 | |
| (217) 398-9066 | |
| (217) 398-9077 |
| Full Name | Kevin Elliott Counseling, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 309 W Clark St, Champaign, Illinois |
| Authorized Official Name and Position | Sandra Ahten (VICE-PRESIDENT/CEO) |
| Authorized Official Contact | 2173989066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Elliott Counseling, Inc. 309 W Clark St Champaign IL 61820-4637 Ph: (217) 398-9066 | Kevin Elliott Counseling, Inc. 309 W Clark St Champaign IL 61820-4637 Ph: (217) 398-9066 |
| NPI Number | 1679937460 |
|---|---|
| Provider Enumeration Date | 04/08/2016 |
| Last Update Date | 04/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679937460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180.004442 (Illinois) | Primary |
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