The Pediatric Clinic For Behavioral Health, PLLC
Counselor, Mental Health in Collinsville, IL. Organization (NPI-2).
NPI number1982439931
StatusActive
Last updated in NPPESJun 21, 2026
Details
- NPI
- 1982439931
- Entity type
- Organization (NPI-2)
- Legal business name
- The Pediatric Clinic For Behavioral Health, PLLC
- Organization subpart
- No
- Enumeration date
- Sep 7, 2024
- Certification date
- Jun 21, 2026
- Last updated
- Jun 21, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
6 Meadow Heights Professional ParkCollinsville, IL 62234-4471
Phone 307-999-6373 · Fax 618-350-0083
Mailing address
6 Meadow Heights Professional ParkCollinsville, IL 62234-4471
Phone 618-493-2631 · Fax 618-350-0083
Authorized official
Bethany Radcliffe
Owner
6184932631
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