Provider Demographics
NPI:1043481088
Name:ASCENT TREATMENT COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:ASCENT TREATMENT COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:REBA
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CDCII
Authorized Official - Phone:907-357-6860
Mailing Address - Street 1:5431 E MAYFLOWER LN STE 5
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7891
Mailing Address - Country:US
Mailing Address - Phone:907-357-6860
Mailing Address - Fax:
Practice Address - Street 1:5431 E MAYFLOWER LN STE 5
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7891
Practice Address - Country:US
Practice Address - Phone:907-357-6860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK908554251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health