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NPI Code Detail

MEDICARE: KALEIDOSCOPE COUNSELING LLC

MEDICARE: KALEIDOSCOPE COUNSELING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1326905621
Entity Type Code : Organization
Provider Name (Legal Business Name) : KALEIDOSCOPE COUNSELING LLC
Provider Business Mailing Address
First Line : 3807 MEMORIAL PKWY NW
Second Line :
City : KENNESAW
State : GA
Zip : 30152-2441
Country : US
Telephone Number : 678-368-2183
Fax Number :
Provider Business Practice Location Address
First Line : 2440 SANDY PLAINS RD BLDG 25
Second Line :
City : MARIETTA
State : GA
Zip : 30066-7232
Country : US
Telephone Number : 770-971-9311
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ERIC BETSILL
Credential : LPC
Telephone Number : 770-971-9311
Provider Enumeration Date : 01/07/2026
Last Update Date : 01/07/2026

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Directions to “KALEIDOSCOPE COUNSELING LLC ” Practice Location

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