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MR. COLEMAN RILEY VIZCARRA
NPI 1770831893
Counselor - Mental Health in Centralia, IL

Active since August 21, 2012
904 E. MARTIN LUTHER KING DR., CENTRALIA, IL 62801(618) 533-1391(618) 533-0012 Get Directions Write a Review

NPPES record last updated: August 21, 2012. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Mr. Coleman Riley Vizcarra NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. COLEMAN RILEY VIZCARRA (NPI 1770831893) is an individual mental health provider in Centralia, Illinois and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1770831893
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. COLEMAN RILEY VIZCARRA
Location Address904 E. MARTIN LUTHER KING DR.Centralia, IL 62801
Mailing Address904 E. Martin Luther King Dr.Centralia, IL 62801 · (618) 533-1391 · Fax (618) 533-0012
Phone(618) 533-1391
Fax(618) 533-0012
Sole ProprietorNo
Enumeration DateAugust 21, 2012
✔ NPI 1770831893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
904 E. MARTIN LUTHER KING DR., Centralia, IL 62801
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. SALLY JOHONNA LINDSAY LCSW
Social Worker (Clinical)
904 E. MARTIN LUTHER KING DR.
CENTRALIA, IL 62801
Marion County (618) 533-1391
JARED G DEERHAKE BS MHP
Counselor
904 E. MARTIN LUTHER KING DR.
CENTRALIA, IL 62801
Marion County (618) 533-1391
AARON DAVIS LCSW
Social Worker (Clinical)
904 E. MARTIN LUTHER KING DR.
CENTRALIA, IL 62801
Marion County (618) 533-1391

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coleman Vizcarra's NPI number?

The NPI number for Coleman Vizcarra is 1770831893. It was assigned to this individual provider in the NPPES registry on August 21, 2012.

Where is Coleman Vizcarra located?

Coleman Vizcarra practices at 904 E. Martin Luther King Dr., Centralia, IL 62801. The listed phone number is (618) 533-1391.

What is Coleman Vizcarra's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Coleman Vizcarra was last updated on August 21, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.