Doctor Name: | DR. PHILLIP J LADD |
NPI Number: | 1255396347 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | |
Business Practice Address: | 3716 W Brighton Ave Peoria, IL - 61615 |
Business Phone Number: | 3096927755 |
Business Fax Number: | 3096922262 |
Mailing Address: | 3716 W Brighton Ave, PEORIA |
State: | IL |
Postal Code: | 61615 |
Phone Number: | 3096927755 |
Fax Number: | 3096922262 |
NPI Enumeration Date: | 04/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |