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General NPI Number Information
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NPI Number | 1184957284
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Entity Type | Organization
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Legal Business Name | RESOLVE COUNSELING SERVICES
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Dates
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Enumeration Date | 09/08/2009
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Last Update Date | 09/08/2009
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Provider Practice Location Address
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Address Line | 3459 ACWORTH DUE WEST RD NW SUITE 565
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City | ACWORTH
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State | GA
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Zip | 30101-5819
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Country | US
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Telephone | 770-330-3418
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Fax |
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Provider Business Mailing Address
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Address Line | 4024 TURNSTONE DR NW
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City | KENNESAW
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State | GA
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Zip | 30152-6420
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Country | US
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Telephone | 770-330-3418
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. DENISE S. ROYSTER
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Credential | LPC, MA
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Telephone | 770-330-3418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LPC050099
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License Number State | GA
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