Provider Demographics
NPI:1295804656
Name:ADVANCED COUNSELING CONCEPTS
Entity type:Organization
Organization Name:ADVANCED COUNSELING CONCEPTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CIRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:718-380-0835
Mailing Address - Street 1:18438 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1516
Mailing Address - Country:US
Mailing Address - Phone:718-380-0835
Mailing Address - Fax:
Practice Address - Street 1:18438 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1516
Practice Address - Country:US
Practice Address - Phone:718-380-0835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008366103TC0700X
NYR04877611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty