Provider Demographics
NPI:1497563993
Name:CLS COUNSELING & CONSULTING, PLLC
Entity type:Organization
Organization Name:CLS COUNSELING & CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SISSOM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCPC
Authorized Official - Phone:618-515-5890
Mailing Address - Street 1:1063 S STATE ROUTE 157 STE 2-128
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3695
Mailing Address - Country:US
Mailing Address - Phone:618-515-5890
Mailing Address - Fax:
Practice Address - Street 1:103 PINE HOLLOW LN
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-4784
Practice Address - Country:US
Practice Address - Phone:618-515-5890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty