Provider Demographics
NPI:1154653673
Name:COUNSELING ALTERNATIVES LLC
Entity Type:Organization
Organization Name:COUNSELING ALTERNATIVES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:765-378-7795
Mailing Address - Street 1:707 ELLERDALE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46017-1427
Mailing Address - Country:US
Mailing Address - Phone:765-378-7795
Mailing Address - Fax:
Practice Address - Street 1:707 ELLERDALE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:IN
Practice Address - Zip Code:46017-1427
Practice Address - Country:US
Practice Address - Phone:765-378-7795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000162A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1376503938OtherINDIVIDUAL NP NUMBER