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NPI Code Detail

MEDICARE: CHESTATEE COUNSELING CENTER

MEDICARE: CHESTATEE COUNSELING CENTER
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
11041C0700XClinical Social WorkerCSW002651GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871726695
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHESTATEE COUNSELING CENTER
Provider Business Mailing Address
First Line : PO BOX 708
Second Line :
City : DAHLONEGA
State : GA
Zip : 30533-0012
Country : US
Telephone Number : 404-386-1090
Fax Number : 678-455-0682
Provider Business Practice Location Address
First Line : 487 MORRISON MOORE PKWY W
Second Line :
City : DAHLONEGA
State : GA
Zip : 30533-1422
Country : US
Telephone Number : 404-386-1090
Fax Number : 678-455-0682
Authorized Official
Title or Position : DIRECTOR
Name : MRS. STACY WOLFF
Credential : LCSW
Telephone Number : 404-386-1090
Provider Enumeration Date : 08/27/2009
Last Update Date : 08/27/2009

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Practice Location Address:
487 MORRISON MOORE PKWY W
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Directions to “CHESTATEE COUNSELING CENTER ” Practice Location

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