| Cisco Counseling Llc | |
|
1504 S Poplar St Centralia IL 62801-5172 | |
| (618) 267-0305 | |
| Not Available |
| Full Name | Cisco Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1504 S Poplar St, Centralia, Illinois |
| Authorized Official Name and Position | Washington Dixon Cisco (CEO) |
| Authorized Official Contact | 6182670305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cisco Counseling Llc 1504 S Poplar St Centralia IL 62801-5172 Ph: (618) 267-0305 | Cisco Counseling Llc 1504 S Poplar St Centralia IL 62801-5172 Ph: (618) 267-0305 |
| NPI Number | 1104616531 |
|---|---|
| Provider Enumeration Date | 05/08/2025 |
| Last Update Date | 05/08/2025 |
| Certification Date | 05/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104616531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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