Provider Demographics
NPI:1396396677
Name:DOWNTOWN COUNSELING GROUP LLC
Entity Type:Organization
Organization Name:DOWNTOWN COUNSELING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:509-592-8268
Mailing Address - Street 1:127 S WASHINGTON ST STE 5
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-2866
Mailing Address - Country:US
Mailing Address - Phone:208-883-9927
Mailing Address - Fax:208-883-9935
Practice Address - Street 1:127 S WASHINGTON ST STE 5
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-2866
Practice Address - Country:US
Practice Address - Phone:208-883-9927
Practice Address - Fax:208-883-9935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty