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General NPI Number Information
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NPI Number | 1235529629
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Entity Type | Organization
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Legal Business Name | CHAPTER 5 COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 01/23/2015
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 822 W GURLEY ST
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City | PRESCOTT
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State | AZ
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Zip | 86305-3624
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Country | US
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Telephone | 928-541-0692
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Fax | 928-237-9768
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Provider Business Mailing Address
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Address Line | 726 W GURLEY ST
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City | PRESCOTT
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State | AZ
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Zip | 86305-3629
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Country | US
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Telephone | 928-541-0692
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Fax | 928-237-9768
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT MORSE
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Credential | BSC
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Telephone | 928-541-0692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | OTC6345
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License Number State | AZ
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