| Source Of Strength Professional Counseling, Pc | |
|
821 Pavilion Ct Suite A Mcdonough GA 30253-5222 | |
| (404) 272-3436 | |
| (404) 855-2887 |
| Full Name | Source Of Strength Professional Counseling, Pc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 821 Pavilion Ct, Mcdonough, Georgia |
| Authorized Official Name and Position | Latrina Graham (OWNER/CEO) |
| Authorized Official Contact | 4042723436 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Source Of Strength Professional Counseling, Pc 2890 Highway 212 Sw Suite A-289 Conyers GA 30094-3363 Ph: (404) 272-3436 | Source Of Strength Professional Counseling, Pc 821 Pavilion Ct Suite A Mcdonough GA 30253-5222 Ph: (404) 272-3436 |
| NPI Number | 1407289721 |
|---|---|
| Provider Enumeration Date | 08/11/2013 |
| Last Update Date | 09/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407289721 | NPI | - | NPPES |
| 003133448A | Medicaid | GA | |
| 003133452A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC006099 (Georgia) | Primary |
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