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Organization

YOUTH SERVICE BUREAU

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIMOTHY B. THARP M.S., LCPC (DIRECTOR)
(812) 423-5816
Entity
Organization

Contact information

Practice address
734 W DELAWARE ST, SUITE 206, EVANSVILLE, IN 47710-1667
(812) 423-5816
(812) 423-5294
Mailing address
734 W DELAWARE ST, SUITE 206, EVANSVILLE, IN 47710-1667
(812) 423-5816
(812) 423-5294

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
39002097A
IN
101YM0800X
Mental Health Counselor
39002097A
IN

Other

Enumeration date
02/18/2010
Last updated
02/18/2010
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