Provider Demographics
NPI:1194420703
Name:ZOETIC ACCORD COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:ZOETIC ACCORD COUNSELING SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:THOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, ADC
Authorized Official - Phone:478-714-3448
Mailing Address - Street 1:2327 PANSY ST SW STE C
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3804
Mailing Address - Country:US
Mailing Address - Phone:256-474-8981
Mailing Address - Fax:
Practice Address - Street 1:2327 PANSY ST SW STE C
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3804
Practice Address - Country:US
Practice Address - Phone:256-474-8981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty