Healthcare Provider Details

I. General information

NPI: 1114330271
Provider Name (Legal Business Name): ASSOCIATES IN COUNSELING AND PSYCHTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 06/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2627 CHARLESTOWN RD
NEW ALBANY IN
47150-2536
US

IV. Provider business mailing address

2627 CHARLESTOWN RD
NEW ALBANY IN
47150-2536
US

V. Phone/Fax

Practice location:
  • Phone: 812-944-1550
  • Fax: 812-725-7865
Mailing address:
  • Phone: 812-944-1550
  • Fax: 812-725-7865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JO LEEN WALSH
Title or Position: OFFICE MANAGER
Credential:
Phone: 812-944-1550