Provider Demographics
NPI:1669604773
Name:COUNSELING SERVICES GROUP
Entity type:Organization
Organization Name:COUNSELING SERVICES GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LPC,CAC
Authorized Official - Phone:484-744-1005
Mailing Address - Street 1:1 N BACTON HILL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1047
Mailing Address - Country:US
Mailing Address - Phone:484-744-1005
Mailing Address - Fax:484-924-9934
Practice Address - Street 1:1 N BACTON HILL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1047
Practice Address - Country:US
Practice Address - Phone:484-744-1005
Practice Address - Fax:484-924-9934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC 000481251S00000X
PAPC000481261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC000481OtherLICENSED PROFESSIONAL COUNSELOR
PAICADC 25103OtherINTERNATIONALLY CERTIFIED ALCOHOL & DRUG COUNSELOR
PA2518OtherCERTIFIED ADDICTIONS COUNSELOR
PA6491OtherCERTIFIED CO-OCCURRING DISORDERS PROFESSIONAL