Individual provider · Type 1 NPI

Faith Basolo, COTA/L

Counselor · Carterville, IL

NPI number 1760835151 Active

Practice location

403 Municipal Dr
Carterville, IL 62918-2042

Call (855) 608-3560 Map

Fax (618) 956-9349

Mailing address

902 W Main St
West Frankfort, IL 62896-2210

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant 224Z00000X057003132 (IL)
Counselor Primary 101Y00000XNone listed

Counselor: 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's degree and clinical experience and supervision for licensure or certification.

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About NPI 1760835151

Faith Basolo, COTA/L's National Provider Identifier is 1760835151, issued on Jul 20, 2016. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Carterville, IL. The record was last updated on Dec 3, 2021.