Provider Demographics
NPI:1568073583
Name:HIGH COUNTRY COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:HIGH COUNTRY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCPC
Authorized Official - Phone:775-962-3025
Mailing Address - Street 1:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:PIOCHE
Mailing Address - State:NV
Mailing Address - Zip Code:89043-0322
Mailing Address - Country:US
Mailing Address - Phone:775-962-3025
Mailing Address - Fax:
Practice Address - Street 1:100 DEPOT AVE, SUITE 7
Practice Address - Street 2:
Practice Address - City:CALIENTE
Practice Address - State:NV
Practice Address - Zip Code:89008
Practice Address - Country:US
Practice Address - Phone:775-962-3025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1982843801OtherINDIVIDUAL NPI
UT1336389048Medicaid