Provider Demographics
NPI:1760812259
Name:EVERYDAY COUNSELING & SERVICES LLC
Entity Type:Organization
Organization Name:EVERYDAY COUNSELING & SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:GOULOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-471-8141
Mailing Address - Street 1:3898 NEW VISION DR
Mailing Address - Street 2:BLDG #13 SUITE #E
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1718
Mailing Address - Country:US
Mailing Address - Phone:260-471-8141
Mailing Address - Fax:260-471-7979
Practice Address - Street 1:3898 NEW VISION DR
Practice Address - Street 2:BLDG #13 SUITE #E
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1718
Practice Address - Country:US
Practice Address - Phone:260-471-8141
Practice Address - Fax:260-471-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-19
Last Update Date:2014-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty