Healthcare Provider Details

I. General information

NPI: 1124541768
Provider Name (Legal Business Name): COUNSELING FIRST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 PLEASANT HOME RD STE B
AUGUSTA GA
30907-3518
US

IV. Provider business mailing address

114 PLEASANT HOME RD STE B
AUGUSTA GA
30907-3518
US

V. Phone/Fax

Practice location:
  • Phone: 706-262-2002
  • Fax:
Mailing address:
  • Phone: 706-262-2002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number308867
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number308867
License Number StateGA

VIII. Authorized Official

Name: MR. JG LONG
Title or Position: MANAGER
Credential: OWNER
Phone: 706-262-2002