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General NPI Number Information
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NPI Number | 1649087529
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Entity Type | Organization
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Legal Business Name | ACT COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 12/14/2024
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 2143 WAGNER TRACE DR
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City | BEAVERCREEK
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State | OH
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Zip | 45431-2976
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Country | US
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Telephone | 210-667-3191
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 340024
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City | DAYTON
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State | OH
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Zip | 45434-0024
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Country | US
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Telephone | 210-667-3191
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. ANTOINETTE C TEGTMEIER
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Credential | LISW-S
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Telephone | 210-667-3191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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