| NPI | 1770548380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA LEEANN LUMPKINS Director 815-334-0411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149001798) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: IL 149007738) |
| 106H00000X Marriage & Family Therapist (Licence: IL 166000105) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2020-08-22 |