Healthcare Provider Details

I. General information

NPI: 1760969950
Provider Name (Legal Business Name): ADVANCED COUNSELING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2018
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4318 WOODCOCK DR STE 120
SAN ANTONIO TX
78228-1315
US

IV. Provider business mailing address

4318 WOODCOCK DR STE 120
SAN ANTONIO TX
78228-1315
US

V. Phone/Fax

Practice location:
  • Phone: 210-544-4471
  • Fax: 210-547-0256
Mailing address:
  • Phone: 210-571-4471
  • Fax: 210-547-0256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number71328
License Number StateTX

VIII. Authorized Official

Name: TERI JOHNSON
Title or Position: OWNER
Credential:
Phone: 210-544-4471