Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shawnee Health Service and Development Corp

Organization Mental Health Counselor · NPI 1053878967

Shawnee Health Service and Development Corp is a Mental Health Counselor in Carbondale, Illinois. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
5
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1025 N Wall St Rm 102
Carbondale, IL 62901-1737
Phone: (618) 519-9200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X
Mental Health Counselor Taxonomy 101YM0800X
Clinical Social Worker Taxonomy 1041C0700X
General Practice Dentistry Taxonomy 1223G0001X
Dental Hygienist Taxonomy 124Q00000X

Record details

NPI number1053878967
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationShawnee Health Service and Development Corp
Authorized official Christina Carney — Ceo · (618) 956-9521
Other names Thomas Elementary School Health Center; Thomas Elementary School Health Center
NPI enumeratedFebruary 27, 2019
Last updated in NPPESJuly 29, 2024
Certification dateJuly 29, 2024
Mailing address109 California St., Po Box 577, Carterville, IL 62918-0577

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