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Organization

INDIGO COUNSELING SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGG RICHARDS LPCC (PRESIDENT)
(419) 775-1771
Entity
Organization

Contact information

Practice address
1230 LEXINGTON AVE STE 100, MANSFIELD, OH 44907-2679
(419) 775-1771
(419) 775-1088
Mailing address
1230 LEXINGTON AVE STE 100, MANSFIELD, OH 44907-2679
(419) 775-1771
(419) 775-1088

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
S1050
OH
103T00000X
Psychologist
4741
OH
103TA0400X
Addiction (Substance Use Disorder) Psychologist
892648
OH

Other

Enumeration date
08/07/2014
Last updated
08/07/2014
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