| Atlanta Christian Counseling Llc | |
|
15 Fish Camp Road Lagrange GA 30240 | |
| (681) 242-7651 | |
| Not Available |
| Full Name | Atlanta Christian Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 15 Fish Camp Road, Lagrange, Georgia |
| Authorized Official Name and Position | Marlena Janette Pique (OWNER/THERAPIST) |
| Authorized Official Contact | 6812427651 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlanta Christian Counseling Llc 112 Buena Vista Dr Long Beach MS 39560-5703 Ph: (681) 242-7651 | Atlanta Christian Counseling Llc 15 Fish Camp Road Lagrange GA 30240 Ph: (681) 242-7651 |
| NPI Number | 1619689742 |
|---|---|
| Provider Enumeration Date | 12/20/2022 |
| Last Update Date | 05/08/2023 |
| Certification Date | 05/08/2023 |
| Medicare PECOS PAC ID | 8426418054 |
|---|---|
| Medicare Enrollment ID | O20230714001080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619689742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marlena Pique |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942569181 PECOS PAC ID: 7719141555 Enrollment ID: I20230714000769 |
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