Provider Demographics
NPI:1396257507
Name:DG COUNSELING LLC
Entity type:Organization
Organization Name:DG COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DECEMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOAD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:502-296-9443
Mailing Address - Street 1:39 CUTLER DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-8944
Mailing Address - Country:US
Mailing Address - Phone:912-417-5787
Mailing Address - Fax:
Practice Address - Street 1:50 AL HENDERSON BLVD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-6001
Practice Address - Country:US
Practice Address - Phone:912-417-5787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty