MEDICARE: SOLID GROUND COUNSELING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1982129722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLID GROUND COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	2515 W ALLEN DR
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65810-1300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2515 W ALLEN DR
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65810-1300
Country	:	US
Telephone Number	:	417-576-8410
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AARON CALLOWAY
Credential	:	MA, LPC
Telephone Number	:	417-576-8410

Provider Enumeration Date	:	08/12/2017
Last Update Date	:	08/15/2023

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