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General NPI Number Information
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NPI Number | 1033675624
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Entity Type | Organization
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Legal Business Name | GOT YOUR SIX COUNSELING, LLC
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 113 E 3RD ST
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City | PITTSBURG
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State | KS
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Zip | 66762-4807
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Country | US
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Telephone | 620-644-3013
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Fax | 620-644-3013
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Provider Business Mailing Address
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Address Line | 702 N LOCUST ST UNIT 1623
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City | PITTSBURG
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State | KS
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Zip | 66762-7850
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Country | US
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Telephone | 254-258-8753
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE COSTELLO
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Credential | LCMFT
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Telephone | 254-258-8753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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