Organization Name: | CRUMBLEY COUNSELING SERVICES LLC |
NPI Number: | 1083967558 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANICKELETTE O CRUMBLEY (OWNER) |
Mailing Address: | 154 E Railroad St Se Pelham |
State: | GA US |
Postal Code: | 317792235 |
Phone Number: | 8662736041 |
Fax Number: | |
NPI Enumeration Date: | 10/22/2012 |
NPI Last Update Date: | 10/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |