Provider Demographics
NPI:1255917274
Name:AG COUNSELING & CONSULTING LLC
Entity type:Organization
Organization Name:AG COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-299-8055
Mailing Address - Street 1:522 S HUNT CLUB BLVD # 256
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4960
Mailing Address - Country:US
Mailing Address - Phone:321-299-8055
Mailing Address - Fax:
Practice Address - Street 1:464 JORDAN STUART CIR APT 118
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-2408
Practice Address - Country:US
Practice Address - Phone:321-299-8055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-21
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003275272OtherNPI