| Douglasville Outpatient Psychological Services | |
|
2722 Stillwater Lake Ln Marietta GA 30066-7906 | |
| (770) 265-8336 | |
| (770) 578-1006 |
| Full Name | Douglasville Outpatient Psychological Services |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2722 Stillwater Lake Ln, Marietta, Georgia |
| Authorized Official Name and Position | Michella Jones (LPC) |
| Authorized Official Contact | 6788389336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglasville Outpatient Psychological Services 8304 Office Park Dr Douglasville GA 30134-6935 Ph: (678) 838-9336 | Douglasville Outpatient Psychological Services 2722 Stillwater Lake Ln Marietta GA 30066-7906 Ph: (770) 265-8336 |
| NPI Number | 1902276686 |
|---|---|
| Provider Enumeration Date | 10/07/2015 |
| Last Update Date | 10/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902276686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC007582 (Georgia) | Primary |
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