Provider Demographics
NPI:1699967638
Name:THE COUNSELING CENTER OF CARTHAGE LLC
Entity type:Organization
Organization Name:THE COUNSELING CENTER OF CARTHAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MS EDS LPC
Authorized Official - Phone:417-358-1220
Mailing Address - Street 1:626 W CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-2846
Mailing Address - Country:US
Mailing Address - Phone:417-358-1220
Mailing Address - Fax:417-358-1947
Practice Address - Street 1:626 W CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-2846
Practice Address - Country:US
Practice Address - Phone:417-358-1220
Practice Address - Fax:417-358-1947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty