Provider Demographics
NPI:1649087529
Name:ACT COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:ACT COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:TEGTMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:210-667-3191
Mailing Address - Street 1:PO BOX 340024
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45434-0024
Mailing Address - Country:US
Mailing Address - Phone:210-667-3191
Mailing Address - Fax:
Practice Address - Street 1:2143 WAGNER TRACE DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2976
Practice Address - Country:US
Practice Address - Phone:210-667-3191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty