Provider Demographics
NPI:1528280740
Name:STARS COUNSELING SERVICES, INC
Entity type:Organization
Organization Name:STARS COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:LATASHA
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAPC
Authorized Official - Phone:770-598-2850
Mailing Address - Street 1:1025 VIOLET ST SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-3748
Mailing Address - Country:US
Mailing Address - Phone:404-254-6539
Mailing Address - Fax:404-420-2325
Practice Address - Street 1:1025 VIOLET ST SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-3748
Practice Address - Country:US
Practice Address - Phone:404-254-6539
Practice Address - Fax:404-420-2325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10071846Medicaid
GA10071763Medicaid