Provider Demographics
NPI:1801199641
Name:COUNSELING AND SUPPORT SERVICES 1 INC
Entity Type:Organization
Organization Name:COUNSELING AND SUPPORT SERVICES 1 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MEIER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW
Authorized Official - Phone:712-224-2774
Mailing Address - Street 1:705 DOUGLAS ST
Mailing Address - Street 2:524
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101-1048
Mailing Address - Country:US
Mailing Address - Phone:712-224-2774
Mailing Address - Fax:712-224-2775
Practice Address - Street 1:705 DOUGLAS ST
Practice Address - Street 2:524
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1048
Practice Address - Country:US
Practice Address - Phone:712-224-2774
Practice Address - Fax:712-224-2775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03843104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty