Provider Demographics
NPI:1184003394
Name:ABC COUNSELING & FAMILY SERVICES
Entity type:Organization
Organization Name:ABC COUNSELING & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCPC
Authorized Official - Phone:309-451-9495
Mailing Address - Street 1:705 E LINCOLN ST
Mailing Address - Street 2:STE 303
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-6406
Mailing Address - Country:US
Mailing Address - Phone:309-451-9495
Mailing Address - Fax:309-451-9404
Practice Address - Street 1:359 MARGARET ST
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-3268
Practice Address - Country:US
Practice Address - Phone:309-349-3886
Practice Address - Fax:309-620-8647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198405251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health