Provider Demographics
NPI:1033834833
Name:VANGUARD COUNSELING, PC
Entity Type:Organization
Organization Name:VANGUARD COUNSELING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BANEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:256-212-0109
Mailing Address - Street 1:PO BOX 1718
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-8718
Mailing Address - Country:US
Mailing Address - Phone:951-317-2775
Mailing Address - Fax:
Practice Address - Street 1:406 WOODFIELD ST SW
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-6003
Practice Address - Country:US
Practice Address - Phone:951-317-2775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)