Provider Demographics
NPI:1124787627
Name:LIVING PROCESS COUNSELING SERVICES CO
Entity type:Organization
Organization Name:LIVING PROCESS COUNSELING SERVICES CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:WYNAT
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:912-429-4714
Mailing Address - Street 1:18 E 61ST ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4116
Mailing Address - Country:US
Mailing Address - Phone:201-616-9263
Mailing Address - Fax:315-750-3205
Practice Address - Street 1:18 E 61ST ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4116
Practice Address - Country:US
Practice Address - Phone:201-616-9263
Practice Address - Fax:315-750-3205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-12
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003266068AMedicaid