Provider Demographics
NPI:1922852458
Name:EAST COUNSELING LLC
Entity Type:Organization
Organization Name:EAST COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:EAST
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:417-379-0045
Mailing Address - Street 1:1523 WILLIAM CT
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-4511
Mailing Address - Country:US
Mailing Address - Phone:417-379-0045
Mailing Address - Fax:
Practice Address - Street 1:1523 WILLIAM CT
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-4511
Practice Address - Country:US
Practice Address - Phone:417-379-0045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty