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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