Provider Demographics
NPI:1235593708
Name:SUMMIT COUNSELING SERVICES
Entity Type:Organization
Organization Name:SUMMIT COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MSW, LICSW
Authorized Official - Phone:701-334-6242
Mailing Address - Street 1:1500 14TH ST W STE 290
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-4078
Mailing Address - Country:US
Mailing Address - Phone:701-334-6242
Mailing Address - Fax:701-712-3299
Practice Address - Street 1:1500 14TH ST W STE 290
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-4078
Practice Address - Country:US
Practice Address - Phone:701-334-6242
Practice Address - Fax:701-712-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4755251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health