Provider Demographics
NPI:1972669844
Name:COUNSEL HOUSE LLC
Entity Type:Organization
Organization Name:COUNSEL HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-738-3277
Mailing Address - Street 1:1585 N OLD HIGHWAY 135
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112-2002
Mailing Address - Country:US
Mailing Address - Phone:812-738-3277
Mailing Address - Fax:812-738-4092
Practice Address - Street 1:1585 N OLD HIGHWAY 135
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-2002
Practice Address - Country:US
Practice Address - Phone:812-738-3277
Practice Address - Fax:812-738-4092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200327030 AMedicaid