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General NPI Number Information
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NPI Number | 1700290434
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE COUNSELING SOLUTIONS LLC
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 06/20/2014
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Provider Practice Location Address
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Address Line | 326 MAIN ST SUITE 209
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City | DELTA
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State | CO
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Zip | 81416-1869
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Country | US
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Telephone | 970-216-1740
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Fax |
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Provider Business Mailing Address
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Address Line | 326 MAIN ST. SUITE 209
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City | DELTA
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State | CO
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Zip | 81416-1862
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Country | US
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Telephone | 970-216-1740
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. THOMAS ALLEN FRIEL
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Credential | M.A., L.O.C.
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Telephone | 970-216-1740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 222
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License Number State | CO
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