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General NPI Number Information
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NPI Number | 1174071666
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Entity Type | Organization
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Legal Business Name | TOTAL CONTROL BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 210 S 13TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-2704
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Country | US
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Telephone | 678-760-5365
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Fax | 866-217-7073
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Provider Business Mailing Address
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Address Line | 748 HIGHWAY 36 E
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City | BARNESVILLE
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State | GA
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Zip | 30204-3248
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Country | US
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Telephone | 678-760-5365
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Fax | 866-217-7073
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Authorized Official
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Title or Position | OWNER
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Name | AARON ROQUEMORE
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Credential | LPC, LMFT
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Telephone | 678-760-5365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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