Individual provider · Type 1 NPI
Kolleen A. Antonacci, LCPC
Addiction (Substance Use Disorder) Counselor · Carbondale, IL
NPI number
1730513409
Active
Practice location
2015 W Main St, Suite 103
Carbondale, IL 62901-2073
Fax (618) 529-3834
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | 180.008168 (IL) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | CADC 2699 (IL) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1730513409
Kolleen A. Antonacci, LCPC's National Provider Identifier is 1730513409, issued on Aug 29, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Carbondale, IL. The record was last updated on Aug 29, 2013.