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General NPI Number Information
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NPI Number | 1134259559
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Entity Type | Organization
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Legal Business Name | CENTER FOR COUNSELING SERVICES
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2150G PEACHFORD RD SUITE G
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City | ATLANTA
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State | GA
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Zip | 30338
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Country | US
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Telephone | 770-394-5447
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Fax | 770-394-5447
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Provider Business Mailing Address
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Address Line | 1802 W NANCY CREEK DR
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City | ATLANTA
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State | GA
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Zip | 30341
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. PAUL GREGORY KAPPHAHN
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Credential | LPC PHD
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Telephone | 770-394-5447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LPC001539
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LPC001424
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License Number State | GA
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