Provider Demographics
NPI:1831646546
Name:ACDI COUNSELING & CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:ACDI COUNSELING & CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER/COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:DUNFORD
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW-IPR, MHR, BA
Authorized Official - Phone:281-513-3859
Mailing Address - Street 1:1423 W PARKWOOD AVE
Mailing Address - Street 2:APT. 2104
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5707
Mailing Address - Country:US
Mailing Address - Phone:281-513-3859
Mailing Address - Fax:281-488-2104
Practice Address - Street 1:16821 BUCCANEER LN
Practice Address - Street 2:SUITE 119
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2544
Practice Address - Country:US
Practice Address - Phone:281-513-3859
Practice Address - Fax:281-488-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-10
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26919101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1649501875OtherTMHP