Healthcare Provider Details

I. General information

NPI: 1467496745
Provider Name (Legal Business Name): B-ONE COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 05/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 SE 2ND ST
EVANSVILLE IN
47713-1109
US

IV. Provider business mailing address

709 SE 2ND ST
EVANSVILLE IN
47713-1109
US

V. Phone/Fax

Practice location:
  • Phone: 812-457-4133
  • Fax:
Mailing address:
  • Phone: 812-457-4133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39000215A
License Number StateIN

VIII. Authorized Official

Name: MRS. BARBARA WITTE
Title or Position: OWNER
Credential: LMHC
Phone: 812-457-4133