Provider Demographics
NPI:1184894099
Name:ASSOCIATED BAY AREA COUNSELORS, INC.
Entity type:Organization
Organization Name:ASSOCIATED BAY AREA COUNSELORS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:419-625-1686
Mailing Address - Street 1:1319 HULL RD
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-6062
Mailing Address - Country:US
Mailing Address - Phone:419-625-1686
Mailing Address - Fax:419-433-9286
Practice Address - Street 1:1319 HULL RD
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-6062
Practice Address - Country:US
Practice Address - Phone:419-625-1686
Practice Address - Fax:419-433-9286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4103103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty