| Mmkg Counseling Services Llc | |
|
1275 Shiloh Rd Nw Ste 3030 Kennesaw GA 30144-7186 | |
| (770) 712-5020 | |
| Not Available |
| Full Name | Mmkg Counseling Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, Georgia |
| Authorized Official Name and Position | Marlo Keenan (LICENSE PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7707125020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmkg Counseling Services Llc 1950 Barrett Lakes Blvd Nw Apt 1226 Kennesaw GA 30144-7535 Ph: (770) 712-5020 | Mmkg Counseling Services Llc 1275 Shiloh Rd Nw Ste 3030 Kennesaw GA 30144-7186 Ph: (770) 712-5020 |
| NPI Number | 1801536438 |
|---|---|
| Provider Enumeration Date | 03/31/2022 |
| Last Update Date | 03/31/2022 |
| Certification Date | 03/31/2022 |
| Medicare PECOS PAC ID | 3779936976 |
|---|---|
| Medicare Enrollment ID | O20240124001170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801536438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Marlo Keenan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326793993 PECOS PAC ID: 2365895505 Enrollment ID: I20240124002563 |
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