| Advance Counseling Services, Llc | |
|
110 Trealout Dr Ste 103 Fenton MI 48430-3211 | |
| (810) 777-0139 | |
| Not Available |
| Full Name | Advance Counseling Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 Trealout Dr Ste 103, Fenton, Michigan |
| Authorized Official Name and Position | Earl E. Hocquard (OWNER) |
| Authorized Official Contact | 8107770139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advance Counseling Services, Llc 110 Trealout Dr Ste 103 Fenton MI 48430-3211 Ph: (810) 777-0139 | Advance Counseling Services, Llc 110 Trealout Dr Ste 103 Fenton MI 48430-3211 Ph: (810) 777-0139 |
| NPI Number | 1669087854 |
|---|---|
| Provider Enumeration Date | 09/14/2020 |
| Last Update Date | 09/30/2020 |
| Medicare PECOS PAC ID | 6800247925 |
|---|---|
| Medicare Enrollment ID | O20240112001415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669087854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Vicki Konczak-miltz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891195772 PECOS PAC ID: 4789032129 Enrollment ID: I20231127000934 |
| Provider Name | Gregory Mcbride |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669829057 PECOS PAC ID: 0749632842 Enrollment ID: I20240113000187 |
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