ICU COUNSELING AND MENTAL HEALTH SUPPORT SERVICES, LLC

Psychologist — Counseling

Code: 103TC1900X

Case Management

Code: 251B00000X

Clinic/Center — Mental Health (Including Community Mental Health Center)

Code: 261QM0801X

Clinic/Center — Adult Mental Health

Code: 261QM0850X

Clinic/Center — Adolescent and Children Mental Health

Code: 261QM0855X

Community/Behavioral Health

Code: 251S00000X