Organization
COMMUNITY COUNSELING SERVICES OF MISSOURI, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ARLENE J O'BRIEN LPC (OWNER)
(417) 260-7707
Entity
Organization
Contact information
Practice address
15423 MCCLOY ROAD, LICKING, MO 65542-0111
(417) 260-7707
Mailing address
PO BOX 111, 15423 MCCLOY ROAD, LICKING, MO 65542-0111
(417) 260-7707
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2010040294
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
2010040294
MO
101YM0800X
Mental Health Counselor
2010040294
MO
101YP2500X
Professional Counselor
Primary
2010040294
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154766806
—
MO
Enumeration date
06/26/2013
Last updated
06/26/2013
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