Provider Demographics
NPI:1275963746
Name:ACHIEVING BEHAVIORAL CONTROL COUNSELING SERVICES ABC COUNSELING SERVIC
Entity Type:Organization
Organization Name:ACHIEVING BEHAVIORAL CONTROL COUNSELING SERVICES ABC COUNSELING SERVIC
Other - Org Name:ABC ACHIEVING BEHAVIORAL CONTROL COUNSELING SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTIANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-773-2063
Mailing Address - Street 1:321 N MALL DR
Mailing Address - Street 2:STE R
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7302
Mailing Address - Country:US
Mailing Address - Phone:435-773-2063
Mailing Address - Fax:
Practice Address - Street 1:321 N MALL DR
Practice Address - Street 2:STE R
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7302
Practice Address - Country:US
Practice Address - Phone:435-773-2063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty