Antonacci, Kolleen A

Antonacci, Kolleen A is an sole proprietor health care provider with primary practice located at 2015 W Main St Suite 103, Carbondale IL 62901-2073. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Antonacci, Kolleen A can be contacted via phone (618) 457-4044.

Contact Information

Primary practice address
2015 W Main St Suite 103 Carbondale IL 62901-2073
Phone: (618) 457-4044
Fax: (618) 529-3834
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 180.008168 Illinois
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CADC 2699 Illinois

Profile Details

NPI number 1730513409
LBN Legal business name Antonacci, Kolleen A
Credentials LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2013
Last updated Aug 29th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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