| Living Hope Counseling Center, Pc | |
|
535 Maine St Suite 13 Quincy IL 62301-3950 | |
| (217) 228-1887 | |
| (217) 228-1884 |
| Full Name | Living Hope Counseling Center, Pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 535 Maine St, Quincy, Illinois |
| Authorized Official Name and Position | Cara Rae Bainum (PRESIDENT & OWNER) |
| Authorized Official Contact | 2172281887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Hope Counseling Center, Pc 535 Maine St Suite 13 Quincy IL 62301-3950 Ph: (217) 228-1887 | Living Hope Counseling Center, Pc 535 Maine St Suite 13 Quincy IL 62301-3950 Ph: (217) 228-1887 |
| NPI Number | 1013044478 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 08/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013044478 | NPI | - | NPPES |
| 1427042076 | Other | INDIVIDUAL NPI # | |
| 491638904 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2006016141 (Missouri) | Secondary |
| 103TC0700X | Psychologist - Clinical | 071-006947 (Illinois) | Primary |
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