Provider Demographics
NPI:1811640063
Name:COUNSELING AVENUES LLC
Entity type:Organization
Organization Name:COUNSELING AVENUES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STROUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-250-0970
Mailing Address - Street 1:2800 N FOREST PARK ST
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-7912
Mailing Address - Country:US
Mailing Address - Phone:316-250-0970
Mailing Address - Fax:
Practice Address - Street 1:330 E MADISON AVE STE 207
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-1736
Practice Address - Country:US
Practice Address - Phone:316-206-3111
Practice Address - Fax:316-252-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSC201151460Medicaid