Healthcare Provider Details

I. General information

NPI: 1366394959
Provider Name (Legal Business Name): EXCEL COUNSELING & BEHAVIORAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5722 GREENRIDGE CT
LITHONIA GA
30058-2202
US

IV. Provider business mailing address

5722 GREENRIDGE CT
LITHONIA GA
30058-2202
US

V. Phone/Fax

Practice location:
  • Phone: 404-597-2390
  • Fax: 404-597-2390
Mailing address:
  • Phone: 404-597-2390
  • Fax: 404-597-2390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: GWENDOLYN RENEE WILLIAMS
Title or Position: MEMBER
Credential: SHUMATE-WILLIAMS
Phone: 404-597-2390