Provider Demographics
NPI:1194155275
Name:SOUTHERN HILLS COUNSELING CENTER
Entity type:Organization
Organization Name:SOUTHERN HILLS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MSW
Authorized Official - Phone:812-482-3020
Mailing Address - Street 1:480 EVERSMAN DR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3548
Mailing Address - Country:US
Mailing Address - Phone:812-482-3020
Mailing Address - Fax:812-482-6409
Practice Address - Street 1:1443 9TH ST
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-1407
Practice Address - Country:US
Practice Address - Phone:812-547-7905
Practice Address - Fax:812-547-5146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33006824A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty