Provider Demographics
NPI:1821153206
Name:CARING COUNSELING MINISTRIES
Entity Type:Organization
Organization Name:CARING COUNSELING MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KENTON
Authorized Official - Last Name:MATTOX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:618-997-2129
Mailing Address - Street 1:1410 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-1910
Mailing Address - Country:US
Mailing Address - Phone:618-997-2129
Mailing Address - Fax:618-997-7972
Practice Address - Street 1:1410 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1910
Practice Address - Country:US
Practice Address - Phone:618-997-2129
Practice Address - Fax:618-997-7972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL204488Medicare ID - Type Unspecified