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General NPI Number Information
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NPI Number | 1194362517
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Entity Type | Organization
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Legal Business Name | ADVANCED COUNSELING LLC
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 39 W PINE AVE
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City | MERIDIAN
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State | ID
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Zip | 83642-2281
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Country | US
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Telephone | 208-887-6283
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Fax | 208-297-6038
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Provider Business Mailing Address
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Address Line | 1426 N CAROL ST
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City | MERIDIAN
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State | ID
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Zip | 83646-1844
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Country | US
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Telephone | 208-887-6283
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Fax | 208-297-6038
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Authorized Official
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Title or Position | OWNER / CLINICAL DIRECTOR
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Name | RODNEY DALE LIMB
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Credential | LCPC, LMFT
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Telephone | 208-887-6283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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