Provider Demographics
NPI:1285476622
Name:ACORN COUNSELING & MEDIATION, LTD
Entity type:Organization
Organization Name:ACORN COUNSELING & MEDIATION, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPICER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-930-2106
Mailing Address - Street 1:101 MCCAUSLAND ST
Mailing Address - Street 2:
Mailing Address - City:CARLINVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62626-9133
Mailing Address - Country:US
Mailing Address - Phone:217-930-2106
Mailing Address - Fax:217-716-2265
Practice Address - Street 1:101 MCCAUSLAND ST
Practice Address - Street 2:
Practice Address - City:CARLINVILLE
Practice Address - State:IL
Practice Address - Zip Code:62626-9133
Practice Address - Country:US
Practice Address - Phone:217-930-2106
Practice Address - Fax:217-716-2265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder