Provider Demographics
NPI:1801941455
Name:4 SIGHT COUNSELING
Entity type:Organization
Organization Name:4 SIGHT COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,
Authorized Official - Phone:573-334-7995
Mailing Address - Street 1:1427 THOMAS DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-2129
Mailing Address - Country:US
Mailing Address - Phone:573-334-7995
Mailing Address - Fax:573-335-8610
Practice Address - Street 1:1427 THOMAS DR
Practice Address - Street 2:SUITE 204
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-2129
Practice Address - Country:US
Practice Address - Phone:573-334-7995
Practice Address - Fax:573-335-8610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO=========Medicaid