Provider Demographics
NPI:1245215003
Name:ADVANCED BEHAVIORAL COUNSELING INC
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:407-960-6808
Mailing Address - Street 1:5703 RED BUG LAKE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4969
Mailing Address - Country:US
Mailing Address - Phone:407-960-6808
Mailing Address - Fax:407-960-3916
Practice Address - Street 1:5703 RED BUG LAKE RD STE 205
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708
Practice Address - Country:US
Practice Address - Phone:407-960-6808
Practice Address - Fax:407-960-3916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2798, MT1711, MH75101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX INDENTIFICATION NUMBE