| Blue Ridge Counseling, Llc | |
|
76 Sandcastle Court Dawsonville GA 30534-7075 | |
| (706) 974-3899 | |
| (866) 242-0878 |
| Full Name | Blue Ridge Counseling, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 76 Sandcastle Court, Dawsonville, Georgia |
| Authorized Official Name and Position | Joseph Mitchell Stapp (PRESIDENT/OWNER) |
| Authorized Official Contact | 7069743899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Counseling, Llc Po Box 2017 Dawsonville GA 30534-0036 Ph: (706) 974-3899 | Blue Ridge Counseling, Llc 76 Sandcastle Court Dawsonville GA 30534-7075 Ph: (706) 974-3899 |
| NPI Number | 1750523387 |
|---|---|
| Provider Enumeration Date | 03/27/2009 |
| Last Update Date | 11/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750523387 | NPI | - | NPPES |
| 11968290 | Other | GA | CAQH/GUHP PROVIDER IDENTIFICATION NUMBER |
| 847805426B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC004711 (Georgia) | Primary |
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