Healthcare Provider Details

I. General information

NPI: 1083722250
Provider Name (Legal Business Name): NORTH GEORGIA COUNSELING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 COMMERCE PKWY UNIT C
CORNELIA GA
30531-5473
US

IV. Provider business mailing address

166 COMMERCE PKWY UNIT C
CORNELIA GA
30531-5473
US

V. Phone/Fax

Practice location:
  • Phone: 706-778-0954
  • Fax: 833-226-0131
Mailing address:
  • Phone: 706-778-0954
  • Fax: 833-226-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW 001239
License Number StateGA

VIII. Authorized Official

Name: MS. KRISTYN STREEVER SNEDDEN
Title or Position: OWNER/SOLE PROVIDER
Credential: MSW, LCSW, ACSW
Phone: 706-839-1008