1588180293 NPI number — COUNSELING ASSOCIATES

Table of content: (NPI 1588180293)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588180293 NPI number — COUNSELING ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNSELING ASSOCIATES
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:
1588180293
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 N KEENE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65201-6625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-874-8818
Provider Business Mailing Address Fax Number:
573-441-2668

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 N KEENE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65201-6625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
(573) 874-8818
Provider Business Practice Location Address Fax Number:
573-441-2668
Provider Enumeration Date:
08/15/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
573-874-8818

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 500046724 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".