Provider Demographics
NPI:1093396517
Name:SOUTHEASTERN COUNSELING, LLC
Entity type:Organization
Organization Name:SOUTHEASTERN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-772-1675
Mailing Address - Street 1:710 EDEN LN
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-3840
Mailing Address - Country:US
Mailing Address - Phone:912-549-3578
Mailing Address - Fax:
Practice Address - Street 1:710 EDEN LN
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-3840
Practice Address - Country:US
Practice Address - Phone:404-772-1675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty