| Breakthrough Counseling Llc | |
|
901 N. Pine Street Suite 101 Rolla MO 65401-3181 | |
| (573) 426-2588 | |
| (573) 426-4859 |
| Full Name | Breakthrough Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 901 N. Pine Street, Rolla, Missouri |
| Authorized Official Name and Position | Gary T. Evans (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5734262588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Counseling Llc 901 N. Pine Street Suite 101 Rolla MO 65401-3181 Ph: (573) 426-2588 | Breakthrough Counseling Llc 901 N. Pine Street Suite 101 Rolla MO 65401-3181 Ph: (573) 426-2588 |
| NPI Number | 1851457840 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851457840 | NPI | - | NPPES |
| $$$$$$$$$ | Other | MO | GARY EVANS SSN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 003819 (Missouri) | Primary |
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