Provider Demographics
NPI:1750980306
Name:AJ FALKERS COUNSELING & CONSULTING SERVICES, LLC
Entity type:Organization
Organization Name:AJ FALKERS COUNSELING & CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FALKERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-501-1189
Mailing Address - Street 1:402 S BLACK RIVER ST STE 125
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-2043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-928-1124
Practice Address - Street 1:402 S BLACK RIVER ST STE 125
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656-2043
Practice Address - Country:US
Practice Address - Phone:608-501-1189
Practice Address - Fax:888-928-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty