Provider Demographics
NPI:1871113274
Name:AT YOUR PACE COUNSELING, LLC
Entity type:Organization
Organization Name:AT YOUR PACE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ELTON
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:260-207-4241
Mailing Address - Street 1:5651 COVENTRY LN STE 179
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7145
Mailing Address - Country:US
Mailing Address - Phone:260-207-4241
Mailing Address - Fax:260-201-9557
Practice Address - Street 1:4646 W JEFFERSON BLVD STE 270
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-6832
Practice Address - Country:US
Practice Address - Phone:260-207-4241
Practice Address - Fax:260-201-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-26
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty