Provider Demographics
NPI:1912338849
Name:BOWLING GREEN COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:BOWLING GREEN COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBBETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-667-1473
Mailing Address - Street 1:18085 HIGHWAY 61
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:MO
Mailing Address - Zip Code:63334-3620
Mailing Address - Country:US
Mailing Address - Phone:573-470-1860
Mailing Address - Fax:417-944-1440
Practice Address - Street 1:310 BUSINESS HWY 61 SOUTH
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:MO
Practice Address - Zip Code:63334-1905
Practice Address - Country:US
Practice Address - Phone:573-470-1860
Practice Address - Fax:417-944-1440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1912338849Medicaid