=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932492212
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACME COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2011
-----------------------------------------------------
Last Update Date | 04/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 310 NW 5TH ST STE 101
-----------------------------------------------------
City | CORVALLIS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97330-4849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-286-4010
-----------------------------------------------------
Fax | 541-286-4011
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 310 NW 5TH ST STE 101
-----------------------------------------------------
City | CORVALLIS
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97330-4849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-286-4010
-----------------------------------------------------
Fax | 541-286-4011
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SUPERVISOR
-----------------------------------------------------
Name | DREW SILVERMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 541-286-4010
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------