Provider Demographics
NPI:1720484959
Name:AMERICAN COUNSELING SERVICE
Entity Type:Organization
Organization Name:AMERICAN COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:915-886-8793
Mailing Address - Street 1:8888 DYER ST
Mailing Address - Street 2:SUITE 419
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-2867
Mailing Address - Country:US
Mailing Address - Phone:915-886-8793
Mailing Address - Fax:
Practice Address - Street 1:8888 DYER ST
Practice Address - Street 2:SUITE 419
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-2867
Practice Address - Country:US
Practice Address - Phone:915-886-8793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68877101YP2500X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty