| Elephant In The Room Counseling Services, Llc | |
|
2320 Wrightsboro Rd Augusta GA 30904-6233 | |
| (706) 750-2809 | |
| Not Available |
| Full Name | Elephant In The Room Counseling Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2320 Wrightsboro Rd, Augusta, Georgia |
| Authorized Official Name and Position | Vivian Smoot Ross (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 7065890660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elephant In The Room Counseling Services, Llc 2320 Wrightsboro Rd Augusta GA 30904-6233 Ph: (706) 750-2809 | Elephant In The Room Counseling Services, Llc 2320 Wrightsboro Rd Augusta GA 30904-6233 Ph: (706) 750-2809 |
| NPI Number | 1225628233 |
|---|---|
| Provider Enumeration Date | 01/23/2021 |
| Last Update Date | 01/23/2021 |
| Certification Date | 01/23/2021 |
| Medicare PECOS PAC ID | 7315484342 |
|---|---|
| Medicare Enrollment ID | O20240807003711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225628233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Vivian Smoot Ross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740797489 PECOS PAC ID: 8224575253 Enrollment ID: I20240807003783 |
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