Provider Demographics
NPI:1740831734
Name:PATRICIA MUYSKENS COUNSELING AND CONSULTATION
Entity type:Organization
Organization Name:PATRICIA MUYSKENS COUNSELING AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUYSKENS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:812-219-1314
Mailing Address - Street 1:715 N PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-3066
Mailing Address - Country:US
Mailing Address - Phone:812-219-1314
Mailing Address - Fax:
Practice Address - Street 1:101 W KIRKWOOD AVE STE 222
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-6133
Practice Address - Country:US
Practice Address - Phone:812-219-1314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty