ILLINI CHRISTIAN MINISTRIES INC (NPI# 1376635078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376635078 |
| Entity Type | Organization |
| Organization Name | ILLINI CHRISTIAN MINISTRIES INC |
| Practice Address |
204 N Main St Suite 203 Saint Joseph IL 61873 |
| Mailing Address |
Po Box 200 204 N. Main Suite 203 Saint Joseph IL 61873-0200 |
| Practice Telephone | 2174697566 |
| Practice Fax Number | 2174692568 |
| Mailing Telephone | 2174697566 |
| Mailing Fax Number | 2174692568 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2010-12-30 |
| Authorized Official Name | MR. TONY Y KIRKMAN (EXEC DIR) |
| Authorized Official Telephone | 2174697566 |
| Authorized Official Credential | LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 180000680 | IL | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 178003791 | IL | Behavioral Health & Social Service Providers |
| Street Address |
204 N MAIN ST SUITE 203 |
| City | SAINT JOSEPH |
| State | IL |
| Zip Code | 61873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104198621 | Tony Yung Kirkman | Counselor | 204 N Main St, Suite 203, Saint Joseph, IL 61873-9355 | 2012-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497175442 | Athletico Ltd | Physical Therapist | 109 N. Main Street, Saint Joseph, IL 61873 | 2014-04-17 |
| 1225182702 | Alina Paul | Family Medicine | 226 E Lincoln, St Joseph, IL 61873 | 2007-01-22 |
| 1750484036 | Edmund R. Rudnicke II, Prof Corp | Dentist | 302 E Lincoln, St Joseph, IL 61873 | 2006-09-05 |
| 1679676951 | Edmund Robert Rudnicke II | Dentist | 302 E Lincoln St, Saint Joseph, IL 61873 | 2006-09-05 |
| 1265618615 | Jmp Counseling and Tutoring Services, LLC | Counselor | 109 N. Main St., St. Joseph, IL 61873 | 2008-01-16 |
| 1942323282 | Bryan Myles Manion | Counselor | 109 N Main St, St Joseph, IL 61873 | 2007-04-10 |
| 1558335703 | Troy Dean Branson | Chiropractor | 109 N Main, St Joseph, IL 61873-0028 | 2006-02-15 |
| 1417950387 | St. Joseph Drugs, Inc. | Pharmacist | 204 N. Main St., Saint Joseph, IL 61873-0500 | 2005-05-24 |
| 1285668830 | St. Joseph Drugs, Inc | Pharmacy | 204 N. Main, St. Joseph, IL 61873-0500 | 2006-07-10 |
| 1780868711 | Chi Kim Le | Dentist | 302 E Lincoln, St Joseph, IL 61873-0678 | 2007-12-27 |
| Find all providers in zip 61873 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710519376 | Gale Sandra Hackworth | Psychologist | 811 Ship St Ste 4b, Saint Joseph, MI 49085-1171 | 2020-02-11 |
| 1063547214 | Richard Reynolds Taylor | Psychologist | 3510 Frederick Ave, Saint Joseph, MO 64506-2987 | 2007-02-21 |
| 1063448918 | Bruce Patrick Hackworth | Psychologist | 811 Ship St, Suite 4b, Saint Joseph, MI 49085-1171 | 2006-06-23 |
| 1861434979 | Shirley Eileen Taylor | Psychologist | 137 N Belt Hwy, Saint Joseph, MO 64506-3491 | 2006-06-12 |
| 1396712071 | Adam Buhman-wiggs | Psychologist | 105 Far West Dr Ste 105, Saint Joseph, MO 64506-3514 | 2006-03-02 |
| 1568457885 | Ilene Fay Schaller | Psychologist | 4208 Kensington Dr, Saint Joseph, MO 64506-4550 | 2005-09-13 |
| 1255331005 | Samaritan Counseling Center Inc. | Psychologist | 902 Edmond St, Ste 203, Saint Joseph, MO 64501-2702 | 2005-07-22 |
| 1699241539 | Sarah Mielens | Psychologist | 3505 Frederick Ave, Saint Joseph, MO 64506-2914 | 2018-10-18 |
| 1740776749 | Elva Whaley | Psychologist | 1030 Miners Rd, Saint Joseph, MI 49085-9625 | 2018-07-03 |
| 1518454701 | Samantha Sanderson Brown | Psychologist | 1030 Miners Rd, Saint Joseph, MI 49085-9625 | 2018-04-13 |
| Find all providers in SAINT JOSEPH | ||||
| City | SAINT JOSEPH |
| Zip Code | 61873 |
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| 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.