| Providence Counseling Services Llc | |
|
1301 Shiloh Rd Nw Ste 840 Kennesaw GA 30144-7147 | |
| (678) 942-1115 | |
| Not Available |
| Full Name | Providence Counseling Services Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1301 Shiloh Rd Nw, Kennesaw, Georgia |
| Authorized Official Name and Position | Joseph Mulligan (OWNER) |
| Authorized Official Contact | 8082485153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Counseling Services Llc 3626 Steinhauer Rd Ne Marietta GA 30066-4755 Ph: (678) 248-5153 | Providence Counseling Services Llc 1301 Shiloh Rd Nw Ste 840 Kennesaw GA 30144-7147 Ph: (678) 942-1115 |
| NPI Number | 1396194163 |
|---|---|
| Provider Enumeration Date | 06/12/2016 |
| Last Update Date | 06/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396194163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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