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General NPI Number Information
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NPI Number | 1942657606
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Entity Type | Organization
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Legal Business Name | COMMUNITY COUNSELING SERVICES OF MISSOURI, L.L.C.
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Dates
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Enumeration Date | 05/23/2016
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 1591 C NORTH HIGHWAY 63
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City | HOUSTON
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State | MO
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Zip | 65483
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Country | US
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Telephone | 417-260-7707
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Fax | 417-967-0710
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Provider Business Mailing Address
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Address Line | 1591 C NORTH HIGHWAY 63
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City | HOUSTON
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State | MO
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Zip | 65483
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Country | US
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Telephone | 417-260-7707
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Fax | 417-967-0710
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ARLENE JEAN O'BRIEN
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Credential | LPC
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Telephone | 417-260-7707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2010040294
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2010040294
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2010040294
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2010040294
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2010040294
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License Number State | MO
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Taxonomy #6
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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