Healthcare Provider Details

I. General information

NPI: 1366287716
Provider Name (Legal Business Name): RBDD COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 06/27/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 GEES MILL RD NE STE 224
CONYERS GA
30013-1361
US

IV. Provider business mailing address

2600 MAIN ST UNIT 171
PORTERDALE GA
30070-3308
US

V. Phone/Fax

Practice location:
  • Phone: 470-444-9891
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ROCHELLE WILSON
Title or Position: OWNER/PROVIDER
Credential: LPC
Phone: 470-444-9891