Healthcare Provider Details

I. General information

NPI: 1043653785
Provider Name (Legal Business Name): RGS & ASSOCIATES COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1882 PRINCETON AVE SUITE 4
COLLEGE PARK GA
30337-3537
US

IV. Provider business mailing address

717 FITZGERALD PL
ATLANTA GA
30349-1086
US

V. Phone/Fax

Practice location:
  • Phone: 404-513-3900
  • Fax:
Mailing address:
  • Phone: 404-513-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC004516
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberLPC
License Number StateGA

VIII. Authorized Official

Name: MRS. RATIMA GUEST SMITH
Title or Position: MANAGING PARTNER
Credential: LPC
Phone: 770-964-2993