| Liberating Counseling Services, Llc | |
|
265 W Pike St Ste 4 Lawrenceville GA 30046-4896 | |
| (770) 284-0906 | |
| (678) 407-4444 |
| Full Name | Liberating Counseling Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 265 W Pike St Ste 4, Lawrenceville, Georgia |
| Authorized Official Name and Position | Ashlenn A. Von Wiegand (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 4702369864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberating Counseling Services, Llc 265 W Pike St Ste 4 Lawrenceville GA 30046-4896 Ph: (770) 284-0906 | Liberating Counseling Services, Llc 265 W Pike St Ste 4 Lawrenceville GA 30046-4896 Ph: (770) 284-0906 |
| NPI Number | 1215514476 |
|---|---|
| Provider Enumeration Date | 03/25/2021 |
| Last Update Date | 04/15/2021 |
| Certification Date | 04/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215514476 | NPI | - | NPPES |
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