Provider Demographics
NPI:1164286415
Name:ASSESSMENT & COUNSELING ASSOCIATES LLC
Entity type:Organization
Organization Name:ASSESSMENT & COUNSELING ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INDEPENDENT CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:FAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LICSW
Authorized Official - Phone:218-441-3631
Mailing Address - Street 1:522 BELTRAMI AVE NW STE 17
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3182
Mailing Address - Country:US
Mailing Address - Phone:218-441-3631
Mailing Address - Fax:218-444-0706
Practice Address - Street 1:522 BELTRAMI AVE NW STE 17
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3182
Practice Address - Country:US
Practice Address - Phone:218-407-2595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty