Provider Demographics
NPI:1760924096
Name:COUNSELING SERVICES OF SOUTH COUNTY
Entity Type:Organization
Organization Name:COUNSELING SERVICES OF SOUTH COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ESCHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,MAC,NCC
Authorized Official - Phone:314-566-4232
Mailing Address - Street 1:4171 CRESCENT DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-3645
Mailing Address - Country:US
Mailing Address - Phone:314-566-4232
Mailing Address - Fax:
Practice Address - Street 1:4171 CRESCENT DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-3645
Practice Address - Country:US
Practice Address - Phone:314-566-4232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004036752101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2004036752OtherLPC