Provider Demographics
NPI:1235744533
Name:INTEGRITY COUNSELING, INC.
Entity Type:Organization
Organization Name:INTEGRITY COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MAHANNAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-827-9100
Mailing Address - Street 1:502 S MORRIS AVE UNIT D
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-4891
Mailing Address - Country:US
Mailing Address - Phone:309-827-9100
Mailing Address - Fax:309-839-4458
Practice Address - Street 1:502 S MORRIS AVE UNIT D
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-4891
Practice Address - Country:US
Practice Address - Phone:309-827-9100
Practice Address - Fax:309-839-4458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-13
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)