Provider Demographics
NPI:1164669479
Name:ADVANCED COUNSELING GROUP,LLC
Entity Type:Organization
Organization Name:ADVANCED COUNSELING GROUP,LLC
Other - Org Name:ADVANCED BEHAVIORAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SOMPONG
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:702-782-7679
Mailing Address - Street 1:3170 E SUNSET RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2745
Mailing Address - Country:US
Mailing Address - Phone:702-782-7689
Mailing Address - Fax:
Practice Address - Street 1:3170 E SUNSET RD
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2745
Practice Address - Country:US
Practice Address - Phone:702-782-7689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2001973.237251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health