Provider Demographics
NPI:1558487090
Name:MT. VERNON COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:MT. VERNON COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARNFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-841-7674
Mailing Address - Street 1:114 ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62837-2945
Mailing Address - Country:US
Mailing Address - Phone:312-841-7674
Mailing Address - Fax:618-270-0524
Practice Address - Street 1:114 ANDREWS DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IL
Practice Address - Zip Code:62837-2945
Practice Address - Country:US
Practice Address - Phone:312-841-7674
Practice Address - Fax:618-270-0524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty