Organization Name: | POSITIVE DIRECTIONS COUNSELING, INC |
NPI Number: | 1841568854 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROXANNE R DOMEK (MENTAL HEALTH COUNSELOR) |
Mailing Address: | 549 Mount Rushmore Rd Ste 1 Custer |
State: | SD US |
Postal Code: | 577301531 |
Phone Number: | 6054402059 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2011 |
NPI Last Update Date: | 12/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC-MH2193 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |