Provider Demographics
NPI:1871893255
Name:SALEM COUNSELING CENTER, P.C.
Entity type:Organization
Organization Name:SALEM COUNSELING CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LCPC
Authorized Official - Phone:618-548-3435
Mailing Address - Street 1:200 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IL
Mailing Address - Zip Code:62881-1532
Mailing Address - Country:US
Mailing Address - Phone:618-548-3435
Mailing Address - Fax:618-548-3435
Practice Address - Street 1:200 N PEARL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IL
Practice Address - Zip Code:62881-1532
Practice Address - Country:US
Practice Address - Phone:618-548-3435
Practice Address - Fax:618-548-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007478251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health