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General NPI Number Information
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NPI Number | 1326829540
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Entity Type | Organization
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Legal Business Name | ADVANCED COUNSELING THERAPY LLC
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 855 N HIGH SCHOOL RD STE 6
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City | INDIANAPOLIS
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State | IN
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Zip | 46214-5702
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Country | US
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Telephone | 615-428-6120
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Fax |
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Provider Business Mailing Address
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Address Line | 110 ZINNIA LN
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City | FRANKLIN
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State | TN
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Zip | 37064-4773
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Country | US
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Telephone | 615-870-2328
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CHRISTA YEARY
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Credential | ESQUIRE
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Telephone | 615-870-2328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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