Provider Demographics
NPI:1306200654
Name:COUNSELING CARE SOLUTIONS, INC
Entity Type:Organization
Organization Name:COUNSELING CARE SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TORTORELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-236-7093
Mailing Address - Street 1:3291 S THOMPSON ST
Mailing Address - Street 2:SUITE E103
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-7043
Mailing Address - Country:US
Mailing Address - Phone:417-236-7093
Mailing Address - Fax:
Practice Address - Street 1:3291 S THOMPSON ST
Practice Address - Street 2:SUITE E103
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-7043
Practice Address - Country:US
Practice Address - Phone:417-236-7093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR000000000Medicaid