Provider Demographics
NPI:1891032538
Name:GRADUATE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:GRADUATE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:513-843-6895
Mailing Address - Street 1:4030 MOUNT CARMEL TOBASCO RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3408
Mailing Address - Country:US
Mailing Address - Phone:513-843-6895
Mailing Address - Fax:
Practice Address - Street 1:4030 MOUNT CARMEL TOBASCO RD STE 102
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3408
Practice Address - Country:US
Practice Address - Phone:513-843-6895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 3160101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE 3160OtherOHIO COUNSELOR BOARD
OHE 3160OtherLPCC-S