Provider Demographics
NPI:1386180487
Name:ADVENT COUNSELING AND TRAINING SERVICES INC
Entity Type:Organization
Organization Name:ADVENT COUNSELING AND TRAINING SERVICES INC
Other - Org Name:ACTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:CIRAKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:404-293-5654
Mailing Address - Street 1:P O BOX 663
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30142
Mailing Address - Country:US
Mailing Address - Phone:404-293-5654
Mailing Address - Fax:770-819-8533
Practice Address - Street 1:4100 KING SPRINGS RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-4207
Practice Address - Country:US
Practice Address - Phone:404-293-5654
Practice Address - Fax:770-819-8533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1557251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA055001241AMedicaid