Healthcare Provider Details
I. General information
NPI: 1649761594
Provider Name (Legal Business Name): 3B COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2018
Last Update Date: 05/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
430 PRIOR ST NE
GAINESVILLE GA
30501-3441
US
IV. Provider business mailing address
2260 TURTLE CREEK WAY
LAWRENCEVILLE GA
30043-6989
US
V. Phone/Fax
- Phone: 678-971-5355
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | GA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUSAN
BAUMANN
Title or Position: COUNSELOR, OWNER
Credential: LPC
Phone: 678-971-5355