Healthcare Provider Details

I. General information

NPI: 1609790583
Provider Name (Legal Business Name): MCC COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 SUNDEW CT
ALPHARETTA GA
30005-4200
US

IV. Provider business mailing address

3300 SUNDEW CT
ALPHARETTA GA
30005-4200
US

V. Phone/Fax

Practice location:
  • Phone: 678-643-2345
  • Fax:
Mailing address:
  • Phone: 678-643-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARTHA CHATLEN
Title or Position: OWNER
Credential:
Phone: 678-643-2345