| Organization Name: | PERRY COUNTY COUNSELING CENTER INC |
| NPI Number: | 1851533996 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN R VENSKUS (EXECUTIVE DIRECTOR) |
| Mailing Address: | 8271 E Jackson Street Rd Du Quoin |
| State: | IL US |
| Postal Code: | 628323811 |
| Phone Number: | 6185426722 |
| Fax Number: | 6185426623 |
| NPI Enumeration Date: | 04/06/2009 |
| NPI Last Update Date: | 04/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149008165 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |