Provider Demographics
NPI:1215202924
Name:COUNSELING SERVICES PLUS, INC
Entity Type:Organization
Organization Name:COUNSELING SERVICES PLUS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:702-877-9850
Mailing Address - Street 1:1240 W OWENS AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-2452
Mailing Address - Country:US
Mailing Address - Phone:702-877-9850
Mailing Address - Fax:702-877-9870
Practice Address - Street 1:1240 W OWENS AVE STE 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-2452
Practice Address - Country:US
Practice Address - Phone:702-877-9850
Practice Address - Fax:702-877-9870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVL791302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization