Provider Demographics
NPI:1962570465
Name:CARTHAGE COUNSELING LLC
Entity type:Organization
Organization Name:CARTHAGE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCSW
Authorized Official - Phone:417-359-8093
Mailing Address - Street 1:2411 FAIRLAWN DR
Mailing Address - Street 2:PO BOX 54
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836
Mailing Address - Country:US
Mailing Address - Phone:417-359-8093
Mailing Address - Fax:417-359-8094
Practice Address - Street 1:2411 FAIRLAWN DR
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836
Practice Address - Country:US
Practice Address - Phone:417-359-8093
Practice Address - Fax:417-359-8094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health