Advanced Counseling Evaluation Treatment and Dui Services
Organization Active NPI Community/Behavioral Health Agency · Normal, IL
NPI 1104378579 · NPPES record last updated Nov 1, 2016
Key facts
- NPI
- 1104378579
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- A75150001A (IL)
- Legal business name
- ADVANCED COUNSELING EVALUATION TREATMENT AND DUI SERVICES
- Practice address
- 705 E Lincoln St
Suite 204
Normal, IL 61761-6406 - Phone
- (309) 808-1017
- NPI assigned
- Nov 1, 2016
- Organization subpart
- No
Authorized official
- Name
- Michael Adam Burash, CSADC
- Title
- Counselor
- Phone
- (815) 343-5691
National Provider Directory
Locations
705 E Lincoln St
Ste 204
Normal, IL 61761
Phone (309) 808-1017
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | A75150001A | IL | Yes |
Addresses
Primary practice location
705 E Lincoln St
Suite 204
Normal, IL 61761-6406
Mailing address
705 E Lincoln St
Suite 204
Normal, IL 61761-6406
Phone (309) 808-1017
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.