MEDICARE: CLS COUNSELING AND CONSULTING 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
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1942182746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLS COUNSELING AND CONSULTING LLC

Provider Business Mailing Address
First Line	:	1669 ELYSE SPRINGS DR
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-4406
Country	:	US
Telephone Number	:	678-308-7817
Fax Number	:

Provider Business Practice Location Address
First Line	:	1669 ELYSE SPRINGS DR
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-4406
Country	:	US
Telephone Number	:	404-884-8002
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHERRICE SMITH
Credential	:	LPC
Telephone Number	:	678-308-7817

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	07/23/2025

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