Provider Demographics
NPI:1528421252
Name:NEO COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:NEO COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHINCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, PCC
Authorized Official - Phone:404-527-8006
Mailing Address - Street 1:9930 JOHNNYCAKE RIDGE RD STE 4F
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6762
Mailing Address - Country:US
Mailing Address - Phone:440-579-5100
Mailing Address - Fax:440-579-5104
Practice Address - Street 1:9930 JOHNNYCAKE RIDGE RD STE 4F
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6762
Practice Address - Country:US
Practice Address - Phone:440-579-5100
Practice Address - Fax:440-579-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OHE1000347101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0208743Medicaid