Provider Demographics
NPI:1255184396
Name:COUNSELING COALITION, LLC
Entity type:Organization
Organization Name:COUNSELING COALITION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:HAYWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-217-2969
Mailing Address - Street 1:PO BOX 7243
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82717-7243
Mailing Address - Country:US
Mailing Address - Phone:970-217-2969
Mailing Address - Fax:
Practice Address - Street 1:801 E 4TH ST STE 9
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4061
Practice Address - Country:US
Practice Address - Phone:307-257-2290
Practice Address - Fax:877-341-0234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care