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General NPI Number Information
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NPI Number | 1205226628
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Entity Type | Organization
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Legal Business Name | ATTENTO COUNSELING PRACTICE
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Dates
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Enumeration Date | 01/24/2015
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Last Update Date | 01/24/2015
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Provider Practice Location Address
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Address Line | 1355 TERRELL MILL RD SE SUITE 200
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City | MARIETTA
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State | GA
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Zip | 30067-5496
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Country | US
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Telephone | 678-641-4455
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Fax |
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Provider Business Mailing Address
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Address Line | 1355 TERRELL MILL RD SE SUITE 200
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City | MARIETTA
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State | GA
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Zip | 30067-5496
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Country | US
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Telephone | 678-641-4455
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MARY ELIZABETH EBINGER
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Credential | M.S.
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Telephone | 678-641-4455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 006243
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License Number State | GA
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