MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS (NPI# 1225282999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225282999 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS |
| Other Organization Name | MEMORIAL BEHAVIORAL HEALTH - JACKSONVILLE |
| Practice Address |
340 W State St Jacksonville IL 62650 |
| Mailing Address |
710 N 8th St Springfield IL 62702-6324 |
| Practice Telephone | 2172456126 |
| Practice Fax Number | 2172454296 |
| Mailing Telephone | 2175251064 |
| Mailing Fax Number | 2175251651 |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2018-06-19 |
| Authorized Official Name | ROBYN L LUKE (ADMINISTRATOR) |
| Authorized Official Telephone | 2175251064 |
| Is Organization Subpart | Y |
| Parent Organization Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Memorial Behavioral Health - Jacksonville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730554692 | Mental Health Centers of Central Illinois | Day Training, Developmentally Disabled Services | 760 S Postville Dr, Lincoln, IL 62656-2237 | 2015-12-03 |
| 1558910794 | Mental Health Centers of Central Illinois | Clinic/Center | 303 E Bidwell St, Taylorville, IL 62568-1363 | 2019-09-10 |
| 1013401322 | Mental Health Centers of Central Illinois | Clinic/Center | 340 W State St, Jacksonville, IL 62650-2061 | 2018-06-20 |
| 1295160323 | Mental Health Centers of Central Illinois | Clinic/Center | 515 N College St, Lincoln, IL 62656-1401 | 2013-09-09 |
| 1225361769 | Mental Health Centers of Central Illinois | Clinic/Center | 200 W Lake Dr, Building A, Springfield, IL 62703-4956 | 2009-09-16 |
| 1750614798 | Mental Health Centers of Central Illinois | Counselor | 901 N 1st St, Suite 225, Springfield, IL 62702-3759 | 2009-09-09 |
| 1023263043 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building C, Springfield, IL 62703-4956 | 2008-11-18 |
| 1932354958 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building D, Springfield, IL 62703-4956 | 2008-11-18 |
| 1841445863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building E, Springfield, IL 62703-4956 | 2008-11-18 |
| 1659525863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Buidling B, Springfield, IL 62703-4956 | 2008-11-14 |
| Street Address |
340 W STATE ST |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437128006 | Kathy Moore Dyson | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2006-03-16 |
| 1629694583 | Elizbeth Huss Secrist | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2020-06-17 |
| 1063058113 | Nora A Bishop | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2019-11-25 |
| 1538644646 | Misty Dawn Spencer | Social Worker | 340 W State St, Jacksonville, IL 62650-2061 | 2018-09-25 |
| 1699253815 | Teegan Rochelle Lund | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2018-07-31 |
| 1013401322 | Mental Health Centers of Central Illinois | Clinic/Center | 340 W State St, Jacksonville, IL 62650-2061 | 2018-06-20 |
| 1558736959 | Christina L. Meads | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2015-12-10 |
| 1164856407 | Yoli S Holmes | Counselor | 340 W State St, Jacksonville, IL 62650-2061 | 2013-08-22 |
| 1649537747 | Betsy Van Brocklin | Social Worker | 340 W State St, Jacksonville, IL 62650-2061 | 2012-04-13 |
| 1972887156 | Debra K Webb | Social Worker | 340 W State St, Jacksonville, IL 62650-2061 | 2011-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184237182 | Anchor Life Clinic | Clinic/Center | 9654 Ragsdale Dr, Jacksonville, FL 32257-6121 | 2020-08-28 |
| 1922637859 | New Patterns Counseling, LLC | Clinic/Center | 1905 Reveille Cir, Jacksonville, AR 72076-9157 | 2020-04-02 |
| 1669019212 | Cass County Mental Health | Clinic/Center | 60 E Central Park Plz, Jacksonville, IL 62650-2071 | 2019-12-03 |
| 1962974766 | Mara's Lighthouse Counseling Center, LLC | Clinic/Center | 6015 Morrow St E Ste 109, Jacksonville, FL 32217-2125 | 2018-12-19 |
| 1417428483 | Recovery Innovations Inc | Clinic/Center | 215b Memorial Dr, Jacksonville, NC 28546-6333 | 2018-12-17 |
| 1386131092 | Renascence Behavioral Healthcare Group, Inc | Clinic/Center | 8553 Argyle Business Loop Ste 1, Jacksonville, FL 32244-6604 | 2018-04-18 |
| 1093231987 | Aspire Psychiatric Services, LLC | Clinic/Center | 625 N 1st St Ste C, Jacksonville, AR 72076-4138 | 2017-08-22 |
| 1598295701 | North Florida Learning & Behavioral Health, LLC | Clinic/Center | 8825 Perimeter Park Blvd Ste 302, Jacksonville, FL 32216-1112 | 2017-06-20 |
| 1700179868 | Chemical Dependency Counseling, Inc. | Clinic/Center | 300 W Adams St Ste 240, Jacksonville, FL 32202-4365 | 2011-05-24 |
| 1952452096 | Psi Services IIi, Inc. | Clinic/Center | 4819 Soutel Dr, Jacksonville, FL 32208-1856 | 2007-01-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
Please comment or provide details below to improve the information on MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.