1821298258 NPI number — DETWEILER COUNSELING SERVICES, INC.

Table of content: (NPI 1821298258)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821298258 NPI number — DETWEILER COUNSELING SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DETWEILER COUNSELING SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821298258
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 KENTUCKY ST
Provider Second Line Business Mailing Address:
SUITE 306
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66044-2823
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-841-0262
Provider Business Mailing Address Fax Number:
785-840-0709

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 KENTUCKY ST
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66044-2823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-841-0262
Provider Business Practice Location Address Fax Number:
785-840-0709
Provider Enumeration Date:
07/24/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DETWEILER
Authorized Official First Name:
DENNIS
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
785-841-0262

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LSCSW-1602 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)