| Indigo Counseling Services, Inc | |
|
1230 Lexington Ave Ste 100 Mansfield OH 44907-2679 | |
| (419) 775-1771 | |
| (419) 775-1088 |
| Full Name | Indigo Counseling Services, Inc |
|---|---|
| Speciality | Counselor |
| Location | 1230 Lexington Ave Ste 100, Mansfield, Ohio |
| Authorized Official Name and Position | Gregg Richards (PRESIDENT) |
| Authorized Official Contact | 4197751771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indigo Counseling Services, Inc 1230 Lexington Ave Ste 100 Mansfield OH 44907-2679 Ph: (419) 775-1771 | Indigo Counseling Services, Inc 1230 Lexington Ave Ste 100 Mansfield OH 44907-2679 Ph: (419) 775-1771 |
| NPI Number | 1821407503 |
|---|---|
| Provider Enumeration Date | 08/07/2014 |
| Last Update Date | 08/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821407503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | S1050 (Ohio) | Primary |
| 103T00000X | Psychologist | 4741 (Ohio) | Secondary |
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | 892648 (Ohio) | Secondary |
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