Provider Demographics
NPI:1821509126
Name:GENERATIONS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:GENERATIONS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOSS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:317-743-8202
Mailing Address - Street 1:435 E MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1457
Mailing Address - Country:US
Mailing Address - Phone:317-743-8202
Mailing Address - Fax:317-743-8276
Practice Address - Street 1:435 E MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1457
Practice Address - Country:US
Practice Address - Phone:317-743-8202
Practice Address - Fax:317-743-8276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009611101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1225476443OtherNPI