Provider Demographics
NPI:1851560577
Name:ACORN COUNSELING LLC
Entity Type:Organization
Organization Name:ACORN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:STANELUIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LICDC
Authorized Official - Phone:419-450-0736
Mailing Address - Street 1:611 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-2027
Mailing Address - Country:US
Mailing Address - Phone:419-893-8432
Mailing Address - Fax:419-891-5403
Practice Address - Street 1:109 W WAYNE ST
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-2150
Practice Address - Country:US
Practice Address - Phone:419-893-8432
Practice Address - Fax:419-891-5403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00010461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9376161Medicare PIN