Healthcare Provider Details

I. General information

NPI: 1598916686
Provider Name (Legal Business Name): IN TOUCH COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 WASHINGTON ST
CLARKESVILLE GA
30523-6011
US

IV. Provider business mailing address

PO BOX 639 562 WASHINGTON STREET
CLARKESVILLE GA
30523-0011
US

V. Phone/Fax

Practice location:
  • Phone: 706-499-8348
  • Fax: 706-754-7145
Mailing address:
  • Phone: 706-499-8348
  • Fax: 706-754-7145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC04335
License Number StateGA

VIII. Authorized Official

Name: MRS. KELLY MICHELLE DAYTON
Title or Position: OWNER
Credential: LPC
Phone: 404-697-9070