Provider Demographics
NPI:1164286415
Name:ASSESSMENT & COUNSELING ASSOCIATES LLC
Entity Type:Organization
Organization Name:ASSESSMENT & COUNSELING ASSOCIATES LLC
Other - Org Name:ASSESSMENT & COUNSELING ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:FAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MA LP
Authorized Official - Phone:218-407-2595
Mailing Address - Street 1:9640 MARCELLA DR NE
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-7030
Mailing Address - Country:US
Mailing Address - Phone:218-407-2595
Mailing Address - Fax:
Practice Address - Street 1:522 BELTRAMI AVE NW STE 17
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3182
Practice Address - Country:US
Practice Address - Phone:218-407-2595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)