| Radiant Counseling, Llc | |
|
513 Gloucester St Brunswick GA 31520-7014 | |
| (912) 580-9580 | |
| (912) 289-9389 |
| Full Name | Radiant Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 513 Gloucester St, Brunswick, Georgia |
| Authorized Official Name and Position | Carrie Ligon (CEO) |
| Authorized Official Contact | 6785954723 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant Counseling, Llc 513 Gloucester St Brunswick GA 31520-7014 Ph: (912) 580-9580 | Radiant Counseling, Llc 513 Gloucester St Brunswick GA 31520-7014 Ph: (912) 580-9580 |
| NPI Number | 1043722705 |
|---|---|
| Provider Enumeration Date | 11/02/2017 |
| Last Update Date | 05/02/2024 |
| Certification Date | 05/02/2024 |
| Medicare PECOS PAC ID | 9133453426 |
|---|---|
| Medicare Enrollment ID | O20190619003363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043722705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tracy K Quintanar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265703649 PECOS PAC ID: 7810151032 Enrollment ID: I20120619000243 |
| Provider Name | Ruth B Ward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467959106 PECOS PAC ID: 3870827116 Enrollment ID: I20190620001970 |
| Provider Name | Charlotte R Nash |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639610249 PECOS PAC ID: 3678807963 Enrollment ID: I20191029000766 |
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