Provider Demographics
NPI:1225647084
Name:ASCENSION COUNSELING GROUP LLC
Entity Type:Organization
Organization Name:ASCENSION COUNSELING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMMY
Authorized Official - Middle Name:B
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-252-2374
Mailing Address - Street 1:9121 N MILITARY TRL STE 207
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5988
Mailing Address - Country:US
Mailing Address - Phone:561-252-2374
Mailing Address - Fax:
Practice Address - Street 1:9121 N MILITARY TRL STE 207
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5988
Practice Address - Country:US
Practice Address - Phone:561-252-2374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health