Provider Demographics
NPI:1912210782
Name:ASSOCIATES IN BEHAVORIAL COUNSELING
Entity Type:Organization
Organization Name:ASSOCIATES IN BEHAVORIAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANNATTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, HSPP
Authorized Official - Phone:765-288-1110
Mailing Address - Street 1:4607 N WHEELING AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-1220
Mailing Address - Country:US
Mailing Address - Phone:765-288-1110
Mailing Address - Fax:765-288-4044
Practice Address - Street 1:4607 N WHEELING AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-1220
Practice Address - Country:US
Practice Address - Phone:765-288-1110
Practice Address - Fax:765-288-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN4251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN25Medicaid