Provider Demographics
NPI:1184635989
Name:CENTER FOR RESOLUTIONS, LLC
Entity Type:Organization
Organization Name:CENTER FOR RESOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:417-773-0413
Mailing Address - Street 1:5425 S FERGUSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810
Mailing Address - Country:US
Mailing Address - Phone:417-773-0413
Mailing Address - Fax:417-862-8659
Practice Address - Street 1:5425 S FERGUSON AVENUE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810
Practice Address - Country:US
Practice Address - Phone:417-773-0413
Practice Address - Fax:417-862-8659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001001603101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO495273328Medicaid