Basic Information
| Provider Information | |||||||||
| NPI: | 1386656015 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED COUNSELING SERVICES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5125 EDWARD JAMES DR | ||||||||
| Address2: | |||||||||
| City: | HOWELL | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488437963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175459344 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7600 GRAND RIVER RD | ||||||||
| Address2: | SUITE 290 | ||||||||
| City: | BRIGHTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481147333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102202787 | ||||||||
| FaxNumber: | 8102202834 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2006 | ||||||||
| LastUpdateDate: | 10/01/2015 | ||||||||
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| AuthorizedOfficialLastName: | LOCK-BRYNE | ||||||||
| AuthorizedOfficialFirstName: | KARYN | ||||||||
| AuthorizedOfficialMiddleName: | LOUISE | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHOTHERAPIST/SITE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8102202787 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | M.A., L.P.C. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 6401005889 | MI | Y | Agencies | Community/Behavioral Health |
No ID Information.