Provider Demographics
NPI:1194046623
Name:MLS COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:MLS COUNSELING SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:STOTTLEMYER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:301-964-0083
Mailing Address - Street 1:P.O. BOX 150
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411
Mailing Address - Country:US
Mailing Address - Phone:301-964-0083
Mailing Address - Fax:304-258-9313
Practice Address - Street 1:3361 VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411
Practice Address - Country:US
Practice Address - Phone:301-964-0083
Practice Address - Fax:304-258-9313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVO802284MOtherOPTIMA HEALTH
WV001818410OtherMOUNTAIN STATE BLUE CROSS BLUE SHIELD
WV309967OtherANTHEM
WV270526OtherCOMPSYCH
WV=========OtherCOMMUNITY HEALTH/INFORMED
WV309967OtherANTHEM
WV=========OtherTRICARE