Provider Demographics
NPI:1346412327
Name:BRANSON COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:BRANSON COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:BOLING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:417-239-1389
Mailing Address - Street 1:574 STATE HIGHWAY 248
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-7740
Mailing Address - Country:US
Mailing Address - Phone:417-239-1389
Mailing Address - Fax:417-332-8680
Practice Address - Street 1:574 STATE HIGHWAY 248
Practice Address - Street 2:SUITE 2
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-7740
Practice Address - Country:US
Practice Address - Phone:417-239-1389
Practice Address - Fax:417-332-8680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-30
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001757251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health