Provider Demographics
NPI:1942988365
Name:ASIC COUNSELING SERVICES
Entity Type:Organization
Organization Name:ASIC COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESSELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-616-0504
Mailing Address - Street 1:2920 OAK PARK CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-1853
Mailing Address - Country:US
Mailing Address - Phone:817-616-0504
Mailing Address - Fax:817-616-0758
Practice Address - Street 1:2920 OAK PARK CIR STE 102
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1853
Practice Address - Country:US
Practice Address - Phone:817-616-0504
Practice Address - Fax:817-616-0758
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASIC RECOVERY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty