Provider Demographics
NPI:1184040131
Name:AMERICAN COUNSELING SERVICE INC
Entity Type:Organization
Organization Name:AMERICAN COUNSELING SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SALENA
Authorized Official - Middle Name:E
Authorized Official - Last Name:WIEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-232-7981
Mailing Address - Street 1:3520 GALLEY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-4344
Mailing Address - Country:US
Mailing Address - Phone:719-963-8740
Mailing Address - Fax:719-570-4323
Practice Address - Street 1:3520 GALLEY RD STE 203
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-4344
Practice Address - Country:US
Practice Address - Phone:719-963-8740
Practice Address - Fax:719-570-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CO1741-01251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty