Provider Demographics
NPI:1174605539
Name:ADVANCED COUNSELING SERVICES
Entity type:Organization
Organization Name:ADVANCED COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VENUS
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SAGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:810-220-2787
Mailing Address - Street 1:220 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:MI
Mailing Address - Zip Code:48451-9004
Mailing Address - Country:US
Mailing Address - Phone:810-220-2787
Mailing Address - Fax:
Practice Address - Street 1:7600 GRAND RIVER RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7333
Practice Address - Country:US
Practice Address - Phone:810-220-2787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401004201251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management