Provider Demographics
NPI:1386656015
Name:ADVANCED COUNSELING SERVICES, PC
Entity Type:Organization
Organization Name:ADVANCED COUNSELING SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/SITE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARYN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:LOCK-BRYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:810-220-2787
Mailing Address - Street 1:5125 EDWARD JAMES DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7963
Mailing Address - Country:US
Mailing Address - Phone:517-545-9344
Mailing Address - Fax:
Practice Address - Street 1:7600 GRAND RIVER RD
Practice Address - Street 2:SUITE 290
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7333
Practice Address - Country:US
Practice Address - Phone:810-220-2787
Practice Address - Fax:810-220-2834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005889251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health