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General NPI Number Information
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NPI Number | 1689758377
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Entity Type | Organization
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Legal Business Name | COUNSELING SERVICES OF PITTSBURG
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 200 W MARSHALL ST
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City | PITTSBURG
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State | TX
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Zip | 75686-1348
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Country | US
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Telephone | 903-856-6001
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Fax | 903-856-0465
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Provider Business Mailing Address
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Address Line | PO BOX 351
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City | LEESBURG
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State | TX
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Zip | 75451-0351
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Country | US
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Telephone | 903-856-6001
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Fax | 903-856-0465
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Authorized Official
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Title or Position | LICENSE PROFESSIONAL COUNSELOR
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Name | CARMEN CONLEY
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Credential | MED, LPC
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Telephone | 903-856-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 12451
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License Number State | TX
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