Provider Demographics
NPI:1528336187
Name:BREMUS COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:BREMUS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BREMUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-210-7100
Mailing Address - Street 1:3500 DULUTH PARK LN
Mailing Address - Street 2:SUITE 410
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3242
Mailing Address - Country:US
Mailing Address - Phone:404-210-7100
Mailing Address - Fax:678-957-0939
Practice Address - Street 1:3500 DULUTH PARK LN
Practice Address - Street 2:SUITE 410
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3242
Practice Address - Country:US
Practice Address - Phone:404-210-7100
Practice Address - Fax:678-957-0939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA32881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty