Provider Demographics
NPI:1952997660
Name:BRIGHT STAR COUNSELING
Entity Type:Organization
Organization Name:BRIGHT STAR COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-231-3962
Mailing Address - Street 1:954 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-3829
Mailing Address - Country:US
Mailing Address - Phone:903-689-2744
Mailing Address - Fax:903-355-2208
Practice Address - Street 1:954 MAIN ST
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-3829
Practice Address - Country:US
Practice Address - Phone:903-689-2744
Practice Address - Fax:903-355-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty