Provider Demographics
NPI:1316167554
Name:ATLANTIC COUNSELING ASSOCIATES
Entity type:Organization
Organization Name:ATLANTIC COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FORBUSH
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-998-2700
Mailing Address - Street 1:4364 ACUSHNET AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-4614
Mailing Address - Country:US
Mailing Address - Phone:508-998-2700
Mailing Address - Fax:508-998-2176
Practice Address - Street 1:4364 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-4614
Practice Address - Country:US
Practice Address - Phone:508-998-2700
Practice Address - Fax:508-998-2176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1019230OtherBEACON HEALTH
043325830OtherHEALTH CARE VALUE MANGMNT