NPI 1083125298

Melissa Shane Counseling Services LLC

Organisation Community/Behavioral Health Agency Peoria, IL

Practice location

Address: 6919 N Knoxville Ave STE 100, Peoria, IL 61614-2858
Phone: (309) 369-3498
Fax: (309) 966-0266

Authorised official

Name: Melissa Ann Shane
Title: Owner
Phone: (309) 369-3498

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 180008837 (IL)

Other Community/Behavioral Health providers in Illinois →

Registry record

NPI: 1083125298
Entity type: Organization
NPI issued: 14 Oct 2017
Record last updated: 14 Oct 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.