Healthcare Provider Details

I. General information

NPI: 1194063198
Provider Name (Legal Business Name): OASIS COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2013
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 LEXINGTON RD STE A
ATHENS GA
30605-2330
US

IV. Provider business mailing address

1720 LEXINGTON RD STE A
ATHENS GA
30605-2330
US

V. Phone/Fax

Practice location:
  • Phone: 706-543-3522
  • Fax: 706-543-3523
Mailing address:
  • Phone: 706-543-3522
  • Fax: 706-543-3523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: STACY DANIEL SAMPSON
Title or Position: OWNER
Credential:
Phone: 706-543-3522