Organization · Type 2 NPI

Itic Support Services Group LLC

Clinical Social Worker · Fairview Heights, IL

NPI number 1972074516 Active

Practice location

141 Market Pl
Fairview Heights, IL 62208-2034

Specialties and licenses

Taxonomy	Code	License
Clinical Social Worker Primary	1041C0700X	None listed
Psychiatry Physician	2084P0800X	None listed
Family Nurse Practitioner	363LF0000X	None listed
Psychiatric/Mental Health Nurse Practitioner	363LP0808X	None listed

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

20 other providers at this address

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NPI record

NPI: 1972074516
Entity type: Organization (Type 2)
Issued: Dec 7, 2018
Last updated: Aug 27, 2019
Status: Active
Subpart: Yes of Itic Support Services Inc

Other names

<unavail>
Itic Support Services · doing business as
Preferred Behavioral Health · doing business as

Authorized official

Mr. Ryan W Morris
Register Agent
(314) 238-5260

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About NPI 1972074516

Itic Support Services Group LLC's National Provider Identifier is 1972074516, issued on Dec 7, 2018. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fairview Heights, IL. The record was last updated on Aug 27, 2019.