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General NPI Number Information
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NPI Number | 1508823535
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Entity Type | Organization
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Legal Business Name | MCAULEY COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 01/05/2008
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Provider Practice Location Address
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Address Line | 2200 E SUNSHINE ST SUITE 334
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City | SPRINGFIELD
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State | MO
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Zip | 65804-1819
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Country | US
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Telephone | 417-823-0498
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Fax | 417-889-5289
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Provider Business Mailing Address
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Address Line | 2200 E SUNSHINE ST SUITE 201
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City | SPRINGFIELD
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State | MO
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Zip | 65804-1819
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Country | US
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Telephone | 417-823-0498
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Fax | 417-889-5289
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR
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Name | VICTORIA M INCRIVAGLIA
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Credential | MSW
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Telephone | 417-823-0498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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