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General NPI Number Information
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NPI Number | 1093474751
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Entity Type | Organization
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Legal Business Name | INTERLINKED COUNSELING AND CONSULTING SERVICES LLC
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 1257 COMMERCIAL DR SW STE A
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City | CONYERS
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State | GA
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Zip | 30094-5991
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Country | US
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Telephone | 770-285-6049
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Fax | 470-207-7902
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Provider Business Mailing Address
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Address Line | 30 MOUNTAIN CREST DR
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City | OXFORD
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State | GA
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Zip | 30054-4181
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Country | US
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Telephone | 478-918-4040
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. D'ANTHONY T HARRIS
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Credential | LPC
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Telephone | 478-918-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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