Organization · NPI-2

Beaconstar Counseling, LLC

Clinic/Center, Rehabilitation, Substance Use Disorder · Springfield, MO

NPI number1710425236

StatusActive

Last updated in NPPESFeb 3, 2017

Details

NPI: 1710425236
Entity type: Organization (NPI-2)
Legal business name: Beaconstar Counseling, LLC
Organization subpart: No
Enumeration date: Feb 3, 2017
Last updated: Feb 3, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	002112 (LPC)	MO	Yes
261QM0850X	Clinic/Center, Adult Mental Health	002112 (LPC)	MO

Practice location

3032 S Fremont Ave
Suite C200
Springfield, MO 65804-4210

Phone 417-882-7827

Mailing address

3032 S Fremont Ave
Suite C200
Springfield, MO 65804-4210

Phone 417-882-7827

Authorized official

Sherry Lynn Peck
Managing Member/Owner
4178827827

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