Provider Demographics
NPI:1427593698
Name:SUMMIT COUNSELING INC
Entity Type:Organization
Organization Name:SUMMIT COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LAC, LACW
Authorized Official - Phone:701-334-6242
Mailing Address - Street 1:1500 14TH ST W
Mailing Address - Street 2:SUITE 290
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-4076
Mailing Address - Country:US
Mailing Address - Phone:701-334-6242
Mailing Address - Fax:701-713-3299
Practice Address - Street 1:1500 14TH ST W
Practice Address - Street 2:SUITE 290
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-4076
Practice Address - Country:US
Practice Address - Phone:701-334-6242
Practice Address - Fax:701-713-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-27
Last Update Date:2020-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1472475Medicaid