Provider Demographics
NPI:1942065198
Name:PEACE CENTER COUNSELING SERVICES
Entity Type:Organization
Organization Name:PEACE CENTER COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:864-609-7396
Mailing Address - Street 1:2613 WESTON ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-3671
Mailing Address - Country:US
Mailing Address - Phone:864-609-7396
Mailing Address - Fax:334-591-2678
Practice Address - Street 1:1716 CATHERINE CT STE 2A
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5735
Practice Address - Country:US
Practice Address - Phone:334-610-0169
Practice Address - Fax:334-591-2678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty