| Ogburn Counseling Services, Llc | |
|
5113 N Executive Dr Ste 101 Peoria IL 61614-4884 | |
| (309) 682-3915 | |
| (309) 679-0703 |
| Full Name | Ogburn Counseling Services, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5113 N Executive Dr Ste 101, Peoria, Illinois |
| Authorized Official Name and Position | Leia A Ogburn (SOLE MEMBER) |
| Authorized Official Contact | 3096823915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ogburn Counseling Services, Llc 5113 N Executive Dr Ste 101 Peoria IL 61614-4884 Ph: (309) 682-3915 | Ogburn Counseling Services, Llc 5113 N Executive Dr Ste 101 Peoria IL 61614-4884 Ph: (309) 682-3915 |
| NPI Number | 1790184182 |
|---|---|
| Provider Enumeration Date | 08/21/2014 |
| Last Update Date | 08/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790184182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149-008753 (Illinois) | Primary |
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