OrganizationActive
Child and Adolescent Neuropsychology Services of Southern Illinois, Pl
NPI 1255961348 · Adolescent and Children Mental Health Clinic/Center · Carbondale, IL
Provider details
- NPI number
- 1255961348
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michelle Kibby-Faglier, Clinical Neuropsychologist(618) 201-8828
Specialties & taxonomies
Ambulatory Health Care Facilities
- Developmental Disabilities Clinic/Center261QD1600X
Ambulatory Health Care Facilities
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
285 Lake Indian Hills Dr
Carbondale, IL 62902-6184
Phone: (618) 490-1263
Street-level locationGet directions
Mailing address
285 Lake Indian Hills Dr
Carbondale, IL 62902-6184
Registry dates
- Enumerated
- 2020-01-17
- Last updated
- 2020-01-17
- Certified
- 2020-01-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.