COMMUNITY LIFE CONCEPTS OF SOUTHERN ILLINOIS, NPC (NPI# 1336292135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336292135 |
| Entity Type | Organization |
| Organization Name | COMMUNITY LIFE CONCEPTS OF SOUTHERN ILLINOIS, NPC |
| Other Organization Name | COMMUNITY LIFE COUNSELING CENTER |
| Practice Address |
473 W Harrison Rd Murphysboro IL 62966-4782 |
| Practice Telephone | 6188672222 |
| Practice Fax Number | 6186873102 |
| Mailing Telephone | 6188672222 |
| Mailing Fax Number | 6186873102 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. PHILIP C NORDSTROM (REGISTERED AGENT) |
| Authorized Official Telephone | 6188672222 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149-0100100 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD IL | 03932042 | 01 |
| IL | HEALTHALLIANCE | 122970 | 01 |
| Other Name | Type Code |
|---|---|
| Community Life Counseling Center | Doing Business As Name - Organization |
| Street Address |
473 W HARRISON RD |
| City | MURPHYSBORO |
| State | IL |
| Zip Code | 62966-4782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144232638 | Melanie Jean Nordstrom | Social Worker | 473 W Harrison Rd, Murphysboro, IL 62966-4782 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093272999 | Lifenet, Inc. | Ambulance | 430 N Airport Rd, Murphysboro, IL 62966 | 2019-02-27 |
| 1538678354 | Anita Tallegien Daneshdoost | Physical Therapist | 1725 Shomaker Drive, Murphysboro, IL 62966 | 2017-09-25 |
| 1295281558 | Alternatives Counseling Inc. | Community/Behavioral Health | 1400 N Wood Road, Murphysboro, IL 62966 | 2016-08-28 |
| 1962855833 | Andrea Maren Whipple | Counselor | 617 Walnut St, Murphysboro, IL 62966 | 2016-07-15 |
| 1730544180 | Lasharon Smith | Non-emergency Medical Transport (VAN) | 37 Nins Lane, Murphysboro, WI 62966 | 2015-12-29 |
| 1710241328 | Kati K Rush | Podiatrist | 19 E Shawnee Dr Ste 3, Murphysboro, IL 62966 | 2012-06-28 |
| 1386709418 | Hoai P Nguyen | Dentist | 1116 Locust Street, Murphysboro, IL 62966 | 2006-12-27 |
| 1154416576 | Hayley Autumn Hood | Occupational Therapist | 6 East Shawnee, Murphysboro, IL 62966 | 2006-10-03 |
| 1356435135 | Southern Illinois Hospital Services | General Acute Care Hospital | 2 South Hospital Drive, Murphysboro, IL 62966 | 2006-10-03 |
| 1699879825 | Stephen Craig Mills | Chiropractor | 1010 N 14th St, Murphysboro, IL 62966 | 2006-09-08 |
| Find all providers in zip 62966 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225544349 | Gary Eugene Trimble | Social Worker | 2023 Logan St, Murphysboro, IL 62966-1754 | 2017-12-27 |
| 1063927291 | Kimberly Renee Mccutchen Brooks | Social Worker | 247 Brenning Rd, Murphysboro, IL 62966-5558 | 2017-12-11 |
| 1972812907 | Colette Ellen Smith | Social Worker | 12 Gilbert Rd, Murphysboro, IL 62966-4624 | 2010-09-24 |
| 1144232638 | Melanie Jean Nordstrom | Social Worker | 473 W Harrison Rd, Murphysboro, IL 62966-4782 | 2006-08-12 |
| 1720447022 | Mary Frances Paskert | Social Worker | 7 S Hospital Dr, Murphysboro, IL 62966-3333 | 2016-02-15 |
| 1992713416 | Donna L Blache | Social Worker | 7 S Hospital Dr, Murphysboro, IL 62966-3333 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851241 | Courtney A Behrens | Social Worker | 150 Deerpath Rd, Algonquin, IL 60102-1861 | 2020-11-06 |
| 1801497623 | Sedulous Counseling & Consulting Services Pllc | Social Worker | 15255 S 94th Ave # 508, Orland Park, IL 60462-3800 | 2020-11-06 |
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1174124036 | Reginald Washington Edwards | Social Worker | 18660 Walnut Ave, Country Club Hills, IL 60478-5549 | 2020-11-05 |
| 1881295186 | Belva Marie Dibert | Social Worker | 6330 S Ingleside Ave Apt 3, Chicago, IL 60637-5784 | 2020-11-03 |
| 1801496468 | Monica Dushane | Social Worker | 125 N Buffalo Grove Rd Apt 110, Buffalo Grove, IL 60089-1722 | 2020-10-31 |
| 1528668373 | Stephanie Caballero Novak | Social Worker | Life Care Wellness, Inc., 800 Roosevelt Rd Building C Suite 206, Glen Ellyn, IL 60137 | 2020-10-30 |
| 1598365488 | Karyssa Lee Haase | Social Worker | 745 E Court St, Paris, IL 61944-2460 | 2020-10-29 |
| 1699375592 | Andrea Doherty | Social Worker | 526 Keystone Ave, River Forest, IL 60305-1612 | 2020-10-29 |
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
| City | MURPHYSBORO |
| Zip Code | 62966 |
Please comment or provide details below to improve the information on COMMUNITY LIFE CONCEPTS OF SOUTHERN ILLINOIS, NPC.
| 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.