OrganizationActive
Community Life Concepts of Southern Illinois, Npc
NPI 1336292135 · Clinical Social Worker · Murphysboro, IL
Provider details
- NPI number
- 1336292135
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Philip Nordstrom, Registered Agent(618) 867-2222
- License
- 149-0100100 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
473 W Harrison Rd
Murphysboro, IL 62966-4782
Phone: (618) 867-2222
Fax: (618) 687-3102
Street-level locationGet directions
Mailing address
473 W Harrison Rd
Murphysboro, IL 62966-4782
Other names (DBA / former)
- Doing business as
- Community Life Counseling Center
Registry dates
- Enumerated
- 2007-01-18
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.