Provider Demographics
NPI:1205959210
Name:HCI COUNSELING SERVICES
Entity type:Organization
Organization Name:HCI COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DIBENEDETTO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:573-875-1576
Mailing Address - Street 1:375 CROWN POINT RD.
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2202
Mailing Address - Country:US
Mailing Address - Phone:573-875-1576
Mailing Address - Fax:573-449-3171
Practice Address - Street 1:375 CROWN POINT RD.
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2202
Practice Address - Country:US
Practice Address - Phone:573-875-1576
Practice Address - Fax:573-449-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO493876023Medicaid