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General NPI Number Information
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NPI Number | 1104546035
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Entity Type | Organization
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Legal Business Name | ADVANCED BEHAVIORAL HEALTH COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 110 W CHURCH ST STE D
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City | SALISBURY
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State | MD
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Zip | 21801-5001
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Country | US
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Telephone | 443-840-0811
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Fax | 410-543-1901
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Provider Business Mailing Address
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Address Line | PO BOX 265
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City | EDEN
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State | MD
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Zip | 21822-0265
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Country | US
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Telephone | 443-840-0811
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Fax | 410-543-1901
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Authorized Official
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Title or Position | ADMINISTRATOR/THERAPIST
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Name | MARSHA BECKETT
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Credential | LCPC
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Telephone | 443-840-0811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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