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General NPI Number Information
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NPI Number | 1205028081
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Entity Type | Organization
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Legal Business Name | A BRIGHTER DAY COUNSELING AND FAMILY SERVICES
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 3114 AUGUSTA TECH DR SUITE 106
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City | AUGUSTA
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State | GA
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Zip | 30906-3300
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Country | US
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Telephone | 706-833-3038
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5338
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City | AUGUSTA
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State | GA
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Zip | 30916-5338
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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 | EXECUTIVE DIRECTOR
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Name | CLYTE LYDIA PORTIS
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Credential | LCSW
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Telephone | 706-833-3038
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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 |
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License Number State |
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