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Organization
TERRE HAUTE COUNSELING SERVICES, LLC
Active
Organization
TERRE HAUTE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET MCBRIDE LCSW (EXECUTIVE DIRECTOR)
(812) 243-9246
Entity
Organization
Contact information
Practice address
2849 E NORTHWOOD AVE, TERRE HAUTE, IN 47805-2621
(812) 243-9246
(812) 917-5091
Mailing address
609 E SURGERY CENTER DR, TERRE HAUTE, IN 47802-6815
(812) 243-9246
(812) 917-5071
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
34002540A
IN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
87001181A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11490495
CAQH
IN
01
—
M400071454
MEDICARE
IN
Enumeration date
11/01/2016
Last updated
11/01/2016
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