Healthcare Provider Details

I. General information

NPI: 1003439696
Provider Name (Legal Business Name): THE COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 S 8TH ST STE 1150
NOBLESVILLE IN
46060-2645
US

IV. Provider business mailing address

23 S 8TH ST STE 1150
NOBLESVILLE IN
46060-2645
US

V. Phone/Fax

Practice location:
  • Phone: 317-754-0808
  • Fax:
Mailing address:
  • Phone: 317-754-0808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. JASON M LYNCH
Title or Position: OWNER/CEO
Credential: MS, LMHCA, LCACA
Phone: 317-754-0808