| Organization Name: | PROVIDENCE COUNSELING & CONSULTING, LLC |
| NPI Number: | 1003232133 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TOAWONDIA T UNDERWOOD (COUNSELOR) |
| Mailing Address: | 500 N Milledge Ave Suite 200 Athens |
| State: | GA US |
| Postal Code: | 306013810 |
| Phone Number: | 4047842585 |
| Fax Number: | 8448789987 |
| NPI Enumeration Date: | 03/13/2014 |
| NPI Last Update Date: | 03/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC007336 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |