Provider Demographics
NPI:1447081625
Name:COOL-ISH COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:COOL-ISH COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OUTPATIENT MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:COOL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:717-880-8651
Mailing Address - Street 1:112 W PENN ST
Mailing Address - Street 2:
Mailing Address - City:NEW FREEDOM
Mailing Address - State:PA
Mailing Address - Zip Code:17349-7900
Mailing Address - Country:US
Mailing Address - Phone:717-880-8651
Mailing Address - Fax:
Practice Address - Street 1:112 W PENN ST
Practice Address - Street 2:
Practice Address - City:NEW FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:17349-7900
Practice Address - Country:US
Practice Address - Phone:717-880-8651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-09
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty