Provider Demographics
NPI:1679280408
Name:LIVING SPRINGS COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:LIVING SPRINGS COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WERMUTH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:417-439-3334
Mailing Address - Street 1:5290 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64801-8757
Mailing Address - Country:US
Mailing Address - Phone:417-623-6134
Mailing Address - Fax:
Practice Address - Street 1:5290 E 7TH ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-8757
Practice Address - Country:US
Practice Address - Phone:417-439-3334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty