Provider Demographics
NPI:1710148168
Name:ASSOCIATED COUNSELING AND CONSULTING SERVICES
Entity Type:Organization
Organization Name:ASSOCIATED COUNSELING AND CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-733-1916
Mailing Address - Street 1:3775 CONSTELLATION RD
Mailing Address - Street 2:STE 3
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-0426
Mailing Address - Country:US
Mailing Address - Phone:805-733-1916
Mailing Address - Fax:805-733-0216
Practice Address - Street 1:3775 CONSTELLATION RD
Practice Address - Street 2:STE 3
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-0426
Practice Address - Country:US
Practice Address - Phone:805-733-1916
Practice Address - Fax:805-733-0216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty