Provider Demographics
NPI:1083081194
Name:AVENUES COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:AVENUES COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JULIUS
Authorized Official - Last Name:WEIMANN
Authorized Official - Suffix:III
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-266-0300
Mailing Address - Street 1:1600 SARNO RD
Mailing Address - Street 2:SUITE 119E
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-4938
Mailing Address - Country:US
Mailing Address - Phone:321-266-0300
Mailing Address - Fax:
Practice Address - Street 1:1600 SARNO RD
Practice Address - Street 2:SUITE 119E
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-4938
Practice Address - Country:US
Practice Address - Phone:321-266-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty