| The Pediatric Clinic For Behavioral Health, Pllc | |
|
2012 Vandalia St Collinsville IL 62234-4848 | |
| (307) 999-6373 | |
| (618) 350-0083 |
| Full Name | The Pediatric Clinic For Behavioral Health, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2012 Vandalia St, Collinsville, Illinois |
| Authorized Official Name and Position | Bethany Radcliffe (OWNER) |
| Authorized Official Contact | 3314424249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Pediatric Clinic For Behavioral Health, Pllc 2012 Vandalia St Collinsville IL 62234-4848 Ph: (307) 999-6373 | The Pediatric Clinic For Behavioral Health, Pllc 2012 Vandalia St Collinsville IL 62234-4848 Ph: (307) 999-6373 |
| NPI Number | 1982439931 |
|---|---|
| Provider Enumeration Date | 09/07/2024 |
| Last Update Date | 01/01/2025 |
| Certification Date | 01/01/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982439931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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