Provider Demographics
NPI:1285336107
Name:NORTH STAR COUNSELING, LLC
Entity type:Organization
Organization Name:NORTH STAR COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LISW-CP
Authorized Official - Phone:803-552-1770
Mailing Address - Street 1:116 STONEGATE DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-9626
Mailing Address - Country:US
Mailing Address - Phone:803-552-1770
Mailing Address - Fax:
Practice Address - Street 1:116 STONEGATE DR
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-9626
Practice Address - Country:US
Practice Address - Phone:803-552-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty