Provider Demographics
NPI:1972662351
Name:WARNER, MICHAEL (MSED, LCPC, CADC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:WARNER
Suffix:
Gender:M
Credentials:MSED, LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 W LINCOLN AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-2455
Mailing Address - Country:US
Mailing Address - Phone:217-348-6281
Mailing Address - Fax:
Practice Address - Street 1:506 W LINCOLN AVE STE 1000
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-2455
Practice Address - Country:US
Practice Address - Phone:217-348-6281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL15502101YA0400X
IL101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional