Provider Demographics
NPI:1134698855
Name:ADVANCED COUNSELING INC
Entity Type:Organization
Organization Name:ADVANCED COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-605-1361
Mailing Address - Street 1:940 MERCHANT ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0627
Mailing Address - Country:US
Mailing Address - Phone:530-605-1361
Mailing Address - Fax:530-605-1363
Practice Address - Street 1:940 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0627
Practice Address - Country:US
Practice Address - Phone:530-605-1361
Practice Address - Fax:530-605-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932265188OtherNPI INDIVIDUAL