Healthcare Provider Details

I. General information

NPI: 1245838366
Provider Name (Legal Business Name): ADVANCED COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 DAVID DR
PATTERSON LA
70392
US

IV. Provider business mailing address

10228 E NORTHWEST HWY UNIT 345
DALLAS TX
75238-4408
US

V. Phone/Fax

Practice location:
  • Phone: 210-504-8179
  • Fax: 210-337-0369
Mailing address:
  • Phone: 210-504-8179
  • Fax: 469-242-9514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. VERNA ALLEN
Title or Position: CO-OWNER
Credential: MSW
Phone: 210-504-8179