Organization Name: | COMMUNITY COUNSELING, INC. |
NPI Number: | 1063606598 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARISSA B NAMIRR (PRESIDENT) |
Mailing Address: | 3950 Cobb Pkwy Nw Suite 708 Acworth |
State: | GA US |
Postal Code: | 301019532 |
Phone Number: | 6786401020 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2007 |
NPI Last Update Date: | 08/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC004505 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |