Provider Demographics
NPI: | 1003803230 |
---|---|
Name: | ALBANY COUNSELING SERVICES, INC |
Entity Type: | Organization |
Organization Name: | ALBANY COUNSELING SERVICES, INC |
Other - Org Name: | THE COUNSELING CENTER |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CLINIC DIRECTOR |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | GRACE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PITTMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 541-928-2710 |
Mailing Address - Street 1: | 936 8TH AVE SW |
Mailing Address - Street 2: | |
Mailing Address - City: | ALBANY |
Mailing Address - State: | OR |
Mailing Address - Zip Code: | 97321-2407 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 541-928-2710 |
Mailing Address - Fax: | 541-928-4301 |
Practice Address - Street 1: | 936 8TH AVE SW |
Practice Address - Street 2: | |
Practice Address - City: | ALBANY |
Practice Address - State: | OR |
Practice Address - Zip Code: | 97321-2407 |
Practice Address - Country: | US |
Practice Address - Phone: | 541-928-2710 |
Practice Address - Fax: | 541-928-4301 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-10-03 |
Last Update Date: | 2011-02-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OR | C0800 | 251B00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251B00000X | Agencies | Case Management |