# FATINO COUNSELING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568985075
- **Authorized official:** CINDY DRAKE (OFFICE MANAGER)
- **Authorized official phone:** (417) 766-8090

## Contact information

- **Practice address:** 1901 WOMMACK AVE, BOLIVAR, MO 65613-3128
- **Practice address phone:** (417) 766-8090
- **Practice address fax:** (417) 777-7017
- **Mailing address:** PO BOX 967, BOLIVAR, MO 65613-0967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 2274 | MO | Yes |

## Other

- **Enumeration date:** 07/18/2017
- **Last updated:** 07/18/2017