MEDICARE: COMPREHENSIVE COUNSELING SOLUTIONS, INC.

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
1	251S00000X	Community/Behavioral Health Agency		GA

General Provider Information

NPI Number	:	1770733214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE COUNSELING SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	3330 CUMBERLAND BLVD
Second Line	:	STE 500
City	:	ATLANTA
State	:	GA
Zip	:	30339-5995
Country	:	US
Telephone Number	:	770-933-6289
Fax Number	:	404-393-9474

Provider Business Practice Location Address
First Line	:	3330 CUMBERLAND BLVD
Second Line	:	STE 500
City	:	ATLANTA
State	:	GA
Zip	:	30339-5995
Country	:	US
Telephone Number	:	770-933-6289
Fax Number	:	404-393-9474

Authorized Official
Title or Position	:	CEO
Name	:	MR. RUSSELL KAWAKAMI
Credential	:
Telephone Number	:	770-933-6289

Provider Enumeration Date	:	09/20/2008
Last Update Date	:	09/20/2008

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