Provider Demographics
NPI:1912377185
Name:COMPLETE LIFE COUNSELING SERVICES
Entity type:Organization
Organization Name:COMPLETE LIFE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-754-8000
Mailing Address - Street 1:1333 CEDAR GROVE RD
Mailing Address - Street 2:PO BOX 311
Mailing Address - City:CONLEY
Mailing Address - State:GA
Mailing Address - Zip Code:30288-2563
Mailing Address - Country:US
Mailing Address - Phone:678-754-8000
Mailing Address - Fax:404-920-2664
Practice Address - Street 1:160 CLAIREMONT AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2500
Practice Address - Country:US
Practice Address - Phone:678-754-8000
Practice Address - Fax:404-920-2664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008225251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health