Provider Demographics
NPI:1619596145
Name:TAG COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:TAG COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ACOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:334-329-8375
Mailing Address - Street 1:1550 OPELIKA RD STE 6-340
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-7618
Mailing Address - Country:US
Mailing Address - Phone:334-329-8375
Mailing Address - Fax:
Practice Address - Street 1:2125 AUTUMN RIDGE WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36879-4639
Practice Address - Country:US
Practice Address - Phone:334-329-8375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty