Provider Demographics
NPI:1801544721
Name:ADVANCED COUNSELING, LLC
Entity type:Organization
Organization Name:ADVANCED COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HYDUKE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:763-760-0464
Mailing Address - Street 1:2415 ANNAPOLIS LN N STE 130
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-3632
Mailing Address - Country:US
Mailing Address - Phone:763-486-2768
Mailing Address - Fax:763-645-2581
Practice Address - Street 1:2415 ANNAPOLIS LN N STE 130
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-3632
Practice Address - Country:US
Practice Address - Phone:763-458-6890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty