Provider Demographics
NPI:1821185513
Name:KISLING, RHEA L (LPC)
Entity type:Individual
Prefix:
First Name:RHEA
Middle Name:L
Last Name:KISLING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 SUSTELLA AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31601-3677
Mailing Address - Country:US
Mailing Address - Phone:229-245-0935
Mailing Address - Fax:229-293-6138
Practice Address - Street 1:3120 N OAK STREET EXT
Practice Address - Street 2:SUITE E
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1007
Practice Address - Country:US
Practice Address - Phone:229-671-6157
Practice Address - Fax:229-293-6138
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004653101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional