Provider Demographics
NPI:1801080627
Name:DIVERSIFIED COUNSELING, INC.
Entity type:Organization
Organization Name:DIVERSIFIED COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-939-9624
Mailing Address - Street 1:620 DERBIGNY ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-6020
Mailing Address - Country:US
Mailing Address - Phone:504-362-0003
Mailing Address - Fax:504-362-0007
Practice Address - Street 1:620 DERBIGNY ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-6020
Practice Address - Country:US
Practice Address - Phone:504-362-0003
Practice Address - Fax:504-362-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health