Provider Demographics
NPI:1073868758
Name:AWARENESS COUNSELING, LLC
Entity Type:Organization
Organization Name:AWARENESS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARICKMAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:LPC-MH
Authorized Official - Phone:605-391-3482
Mailing Address - Street 1:809 SOUTH ST.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701
Mailing Address - Country:US
Mailing Address - Phone:605-391-3482
Mailing Address - Fax:605-342-8144
Practice Address - Street 1:809 SOUTH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701
Practice Address - Country:US
Practice Address - Phone:605-391-3482
Practice Address - Fax:605-342-8144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10249596UT251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6575762Medicaid