Provider Demographics
NPI:1598149007
Name:ACKLEY COUNSELING & EMPLOYMENT SERVICES
Entity Type:Organization
Organization Name:ACKLEY COUNSELING & EMPLOYMENT SERVICES
Other - Org Name:DARYL ACKLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:ACKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-826-8344
Mailing Address - Street 1:10 S BARTLETT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-7204
Mailing Address - Country:US
Mailing Address - Phone:541-826-8344
Mailing Address - Fax:
Practice Address - Street 1:10 S BARTLETT ST STE 202
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7204
Practice Address - Country:US
Practice Address - Phone:541-826-8344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDZ1069251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORDZ1069Medicaid