Provider Demographics
NPI:1629690672
Name:SUMMIT COUNSELING CENTER
Entity Type:Organization
Organization Name:SUMMIT COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:STUTE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:818-681-8085
Mailing Address - Street 1:4390 CLEARWATER WAY APT 3307
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-6396
Mailing Address - Country:US
Mailing Address - Phone:818-681-8085
Mailing Address - Fax:502-353-0640
Practice Address - Street 1:145 BURT RD STE 19
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2401
Practice Address - Country:US
Practice Address - Phone:818-681-8085
Practice Address - Fax:502-353-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty