Provider Demographics
NPI:1750126041
Name:ALI COUNSELING GROUP SERVICES INC
Entity type:Organization
Organization Name:ALI COUNSELING GROUP SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAMEKA
Authorized Official - Middle Name:TAWANN
Authorized Official - Last Name:SELLS-MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:502-500-4452
Mailing Address - Street 1:653 WINDBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-6827
Mailing Address - Country:US
Mailing Address - Phone:502-500-4452
Mailing Address - Fax:
Practice Address - Street 1:312 N MULBERRY ST STE 107
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-1837
Practice Address - Country:US
Practice Address - Phone:502-500-4452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty