Provider Demographics
NPI:1902238777
Name:ACADIAN COUNSELING SERVICE, LLC
Entity Type:Organization
Organization Name:ACADIAN COUNSELING SERVICE, LLC
Other - Org Name:ACADIAN COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WIHONGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-836-1161
Mailing Address - Street 1:796 E PACIFIC DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3161
Mailing Address - Country:US
Mailing Address - Phone:801-642-2491
Mailing Address - Fax:801-216-4566
Practice Address - Street 1:796 E PACIFIC DR
Practice Address - Street 2:SUITE A
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-3161
Practice Address - Country:US
Practice Address - Phone:801-642-2491
Practice Address - Fax:801-216-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT86346940160261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)