MEDICARE: ADVANCED COUNSELING & RECOVERY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	6301013481	MI
3	103TC0700X	Clinical Psychologist
4	261Q00000X	Clinic/Center
5	101YM0800X	Mental Health Counselor	6301013481	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6301013481	OTHER	MI	STATE OF MICHIGAN LLP LICENSE
2	103TC0700X	OTHER	MI	NPI PSYCHOLOGIST-CLINICAL
3	6361005801	OTHER	MI	PSYCHOLOGICAL ASSOCIATE MASTERS LIMITED PSYCHOLOGIST LICENSE

General Provider Information

NPI Number	:	1538605019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED COUNSELING & RECOVERY LLC

Provider Business Mailing Address
First Line	:	1112 CATALPA DR
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48067-1125
Country	:	US
Telephone Number	:	248-915-4127
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 CATALPA DR
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48067-1125
Country	:	US
Telephone Number	:	248-915-4127
Fax Number	:	248-581-4280

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KIRK DAVID DUNCAN
Credential	:	PHD LLP LPC
Telephone Number	:	248-915-4127

Provider Enumeration Date	:	01/09/2017
Last Update Date	:	04/09/2025

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