Organization
BRIGHTSIDE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LACEY MARIE WILSON MS, LPC (OWNER)
(417) 693-0120
Entity
Organization
Contact information
Practice address
304 E JACKSON ST STE 3B, WILLARD, MO 65781-9472
(417) 730-9198
(417) 222-3367
Mailing address
105 PEBBLE CREEK LN, WILLARD, MO 65781-8152
(417) 693-0120
(417) 222-3367
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740681394
—
MO
Enumeration date
05/21/2025
Last updated
05/21/2025
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