Provider Demographics
NPI:1942516232
Name:ADVANCE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:ADVANCE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIOGUARDI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-326-2333
Mailing Address - Street 1:PO BOX 860
Mailing Address - Street 2:SUITE 202A
Mailing Address - City:SOLOMONS
Mailing Address - State:MD
Mailing Address - Zip Code:20688-0860
Mailing Address - Country:US
Mailing Address - Phone:410-326-2333
Mailing Address - Fax:410-326-6868
Practice Address - Street 1:14350 SOLOMONS ISLAND ROAD
Practice Address - Street 2:SUITE 202 A
Practice Address - City:SOLOMONS
Practice Address - State:MD
Practice Address - Zip Code:20688
Practice Address - Country:US
Practice Address - Phone:410-326-2333
Practice Address - Fax:410-326-6868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty