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General NPI Number Information
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NPI Number | 1386418358
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Entity Type | Organization
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Legal Business Name | ADVANTAGE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 71 WILSON BLVD SUITE A01
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City | FISHERSVILLE
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State | VA
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Zip | 22939
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Country | US
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Telephone | 540-836-3659
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Fax | 434-465-6950
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Provider Business Mailing Address
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Address Line | 1233 FREDERICK ST
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City | WAYNESBORO
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State | VA
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Zip | 22980-5507
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Country | US
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Telephone | 540-836-3659
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Fax | 434-465-6950
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | MARY POWELL
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Credential | LPC, MFTL, LSATP
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Telephone | 540-836-3659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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