Provider Demographics
NPI:1710214028
Name:COUNSELING CONNECTIONS L.L.C.
Entity Type:Organization
Organization Name:COUNSELING CONNECTIONS L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, DCC
Authorized Official - Phone:636-931-0300
Mailing Address - Street 1:206 B EAST MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-1907
Mailing Address - Country:US
Mailing Address - Phone:636-931-0300
Mailing Address - Fax:636-933-3510
Practice Address - Street 1:206 B EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-1907
Practice Address - Country:US
Practice Address - Phone:636-931-0300
Practice Address - Fax:636-933-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO494659212Medicaid