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General NPI Number Information
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NPI Number | 1245615814
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC COUNSELING AND CONSULTING SERVICES LLC
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 34 PLEASANT ST STE 2
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City | MORRISVILLE
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State | VT
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Zip | 05661
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Country | US
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Telephone | 802-498-7339
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1291 34 PLEASANT ST STE 2
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City | MORRISVILLE
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State | VT
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Zip | 05661
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Country | US
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Telephone | 802-498-7339
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Fax | 802-851-8290
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA MASON
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Credential | LCMHC
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Telephone | 802-498-7339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0680057761
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License Number State | VT
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