| Ridgeline Counseling Llc | |
|
4343 Shallowford Rd Suite C2 Marietta GA 30062-5023 | |
| (770) 993-9700 | |
| (770) 993-9800 |
| Full Name | Ridgeline Counseling Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4343 Shallowford Rd, Marietta, Georgia |
| Authorized Official Name and Position | David G Markwell (OWNER) |
| Authorized Official Contact | 7709939700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ridgeline Counseling Llc 4343 Shallowford Rd Suite C2 Marietta GA 30062-5023 Ph: (770) 993-9700 | Ridgeline Counseling Llc 4343 Shallowford Rd Suite C2 Marietta GA 30062-5023 Ph: (770) 993-9700 |
| NPI Number | 1508058389 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 05/13/2011 |
| Medicare PECOS PAC ID | 6103262589 |
|---|---|
| Medicare Enrollment ID | O20240307002057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508058389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3565 (Georgia) | Primary |
| Provider Name | David G Markwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336173541 PECOS PAC ID: 0446696835 Enrollment ID: I20240325003886 |
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