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General NPI Number Information
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NPI Number | 1326387523
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Entity Type | Organization
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Legal Business Name | COUNSELING PARTNERS LLC
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Dates
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Enumeration Date | 02/07/2013
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Last Update Date | 02/07/2013
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Provider Practice Location Address
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Address Line | 115 FARABEE DR N SUITE B2
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City | LAFAYETTE
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State | IN
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Zip | 47905-5913
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Country | US
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Telephone | 765-427-6756
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Fax | 765-423-5600
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Provider Business Mailing Address
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Address Line | 115 FARABEE DR N SUITE B2
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City | LAFAYETTE
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State | IN
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Zip | 47905-5913
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Country | US
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Telephone | 765-427-6756
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Fax | 765-423-5600
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Authorized Official
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Title or Position | CEO
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Name | MRS. VIVIAN LEUCK
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Credential | MS
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Telephone | 765-427-6756
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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