Provider Demographics
NPI:1447598487
Name:ADVANTAGE COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:ADVANTAGE COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:573-253-9966
Mailing Address - Street 1:7888 AUDRAIN ROAD 355
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-5816
Mailing Address - Country:US
Mailing Address - Phone:573-253-9966
Mailing Address - Fax:417-944-1440
Practice Address - Street 1:116 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-2842
Practice Address - Country:US
Practice Address - Phone:573-253-9966
Practice Address - Fax:417-944-1440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty