| Advanced Counseling For Change, Pllc | |
|
424 3rd St Se Devils Lake ND 58301-3605 | |
| (701) 351-1182 | |
| (701) 662-6234 |
| Full Name | Advanced Counseling For Change, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 424 3rd St Se, Devils Lake, North Dakota |
| Authorized Official Name and Position | Lisa R Hawley (DIRECTOR/OWNER) |
| Authorized Official Contact | 7013511182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Counseling For Change, Pllc 424 3rd St Se Devils Lake ND 58301-3605 Ph: (701) 351-1182 | Advanced Counseling For Change, Pllc 424 3rd St Se Devils Lake ND 58301-3605 Ph: (701) 351-1182 |
| NPI Number | 1700026317 |
|---|---|
| Provider Enumeration Date | 02/23/2009 |
| Last Update Date | 02/23/2009 |
| Medicare PECOS PAC ID | 3173670726 |
|---|---|
| Medicare Enrollment ID | O20090416000462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700026317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2645 (North Dakota) | Primary |
| Provider Name | Lisa R Hawley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891996179 PECOS PAC ID: 4385714872 Enrollment ID: I20080610000755 |
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