Provider Demographics
NPI:1013546530
Name:COUNSELORS ON CALL LLC
Entity type:Organization
Organization Name:COUNSELORS ON CALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:SEBASTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LISAC
Authorized Official - Phone:928-308-5033
Mailing Address - Street 1:309 DOUBLE D DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86303-5811
Mailing Address - Country:US
Mailing Address - Phone:303-420-1399
Mailing Address - Fax:
Practice Address - Street 1:240 S MONTEZUMA ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-4712
Practice Address - Country:US
Practice Address - Phone:928-224-5257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNSELORS ON CALL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health