Provider Demographics
NPI:1639677156
Name:SALUS COUNSELING LLC
Entity Type:Organization
Organization Name:SALUS COUNSELING LLC
Other - Org Name:REYNOLDS COUNSELING & ASSOCIATES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:LCPC
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:309-822-2261
Mailing Address - Street 1:2103 E WASHINGTON ST STE 4B
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-4362
Mailing Address - Country:US
Mailing Address - Phone:309-822-2261
Mailing Address - Fax:866-226-2435
Practice Address - Street 1:2103 E WASHINGTON ST STE 4B
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-4362
Practice Address - Country:US
Practice Address - Phone:217-871-3001
Practice Address - Fax:866-226-2435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.101585101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1376930024Medicaid