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General NPI Number Information
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NPI Number | 1467565143
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Entity Type | Organization
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Legal Business Name | COUNSELING ASSOCIATES OF SOUTHERN INDIANA, PSC
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1919 STATE ST SUITE 18
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City | NEW ALBANY
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State | IN
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Zip | 47150-4929
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Country | US
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Telephone | 812-949-1435
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Fax | 812-949-9792
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Provider Business Mailing Address
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Address Line | 1919 STATE ST SUITE 18
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City | NEW ALBANY
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State | IN
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Zip | 47150-4929
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Country | US
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Telephone | 812-949-1435
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Fax | 812-949-9792
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | FAIRY PEARCE
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Credential |
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Telephone | 812-949-1435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | IN
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