| Organization Name: | COURAGEOUS LIVING COUNSELING SERVICES, LLC |
| NPI Number: | 1720322761 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLEY LYNN GIANNETTI (PARTNER AND PROFESSIONAL COUNSELOR) |
| Mailing Address: | 1314 E Philadelphia Ave Gilbertsville |
| State: | PA US |
| Postal Code: | 195259338 |
| Phone Number: | 2158591252 |
| Fax Number: | 2157015726 |
| NPI Enumeration Date: | 11/15/2012 |
| NPI Last Update Date: | 09/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC006492 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |