Provider Demographics
NPI:1558016378
Name:NATIONAL CENTER OF COUNSELING SERVICES AND TRAINING LLC
Entity Type:Organization
Organization Name:NATIONAL CENTER OF COUNSELING SERVICES AND TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERI LYNN
Authorized Official - Middle Name:KU'ULEI
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MPHIL, LMHC
Authorized Official - Phone:808-723-9186
Mailing Address - Street 1:PO BOX 370504
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-0504
Mailing Address - Country:US
Mailing Address - Phone:808-723-9186
Mailing Address - Fax:
Practice Address - Street 1:3200 PARAGON POINTE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6702
Practice Address - Country:US
Practice Address - Phone:808-723-9186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty