Provider Demographics
NPI:1033675624
Name:GOT YOUR SIX COUNSELING, LLC
Entity Type:Organization
Organization Name:GOT YOUR SIX COUNSELING, LLC
Other - Org Name:GOT YOUR SIX COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:254-258-8753
Mailing Address - Street 1:702 N LOCUST ST UNIT 1623
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-7850
Mailing Address - Country:US
Mailing Address - Phone:254-258-8753
Mailing Address - Fax:
Practice Address - Street 1:113 E 3RD ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-4807
Practice Address - Country:US
Practice Address - Phone:620-644-3013
Practice Address - Fax:620-644-3013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1861761462OtherINDIVIDUAL NPI