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General NPI Number Information
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NPI Number | 1023086105
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Entity Type | Organization
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Legal Business Name | STRESSCARE, INC.
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1030 VILLAGE DR
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City | WATKINSVILLE
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State | GA
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Zip | 30677-6004
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Country | US
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Telephone | 706-769-1718
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Fax | 706-769-4535
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Provider Business Mailing Address
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Address Line | 1030 VILLAGE DR
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City | WATKINSVILLE
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State | GA
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Zip | 30677
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Country | US
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Telephone | 706-769-1718
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Fax | 706-769-4535
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MR. PAUL R. COLE
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Credential | LCSW
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Telephone | 706-769-1718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 001572
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License Number State | GA
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