Provider Demographics
NPI:1164517934
Name:OZARK COUNSELING CENTER
Entity Type:Organization
Organization Name:OZARK COUNSELING CENTER
Other - Org Name:GREENE COUNTY GUIDANCE CLINIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:417-869-9011
Mailing Address - Street 1:614 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65806-3110
Mailing Address - Country:US
Mailing Address - Phone:417-869-9011
Mailing Address - Fax:471-889-6307
Practice Address - Street 1:614 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65806-3110
Practice Address - Country:US
Practice Address - Phone:417-869-9011
Practice Address - Fax:471-889-6307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty