Provider Demographics
NPI:1598303224
Name:NOVA COUNSELING AND CONSULTING SERVICES, LLC
Entity type:Organization
Organization Name:NOVA COUNSELING AND CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:MCNAIR
Authorized Official - Last Name:KNIGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:ED D
Authorized Official - Phone:229-347-3384
Mailing Address - Street 1:2704 QUAIL RUN DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31721-8837
Mailing Address - Country:US
Mailing Address - Phone:229-347-3384
Mailing Address - Fax:229-518-6628
Practice Address - Street 1:1142 DAWSON RD STE 103
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-6800
Practice Address - Country:US
Practice Address - Phone:229-347-3384
Practice Address - Fax:229-518-6628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty