Provider Demographics
NPI:1962895771
Name:COUNSELING SERVICES OF GEORGIA, LLC
Entity type:Organization
Organization Name:COUNSELING SERVICES OF GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-337-9294
Mailing Address - Street 1:3469 MACON RD
Mailing Address - Street 2:#6422
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31917-7701
Mailing Address - Country:US
Mailing Address - Phone:770-337-9294
Mailing Address - Fax:
Practice Address - Street 1:3469 MACON RD
Practice Address - Street 2:#6422
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31917-7701
Practice Address - Country:US
Practice Address - Phone:770-337-9294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health