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General NPI Number Information
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NPI Number | 1215383633
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Entity Type | Organization
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Legal Business Name | AUSTIN AHLEXANDRIA COUNSELING & TRAINING LLC
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 8301B OFFICE PARK DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-6935
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Country | US
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Telephone | 678-549-3259
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Fax |
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Provider Business Mailing Address
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Address Line | 2592 WINDING CREEK DR
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City | LITHIA SPRINGS
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State | GA
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Zip | 30122-2761
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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 | CEO
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Name | MRS. TREVA LANIECE SEXTON
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Credential |
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Telephone | 770-288-0255
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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 | APC004846
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | APC004846
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License Number State | GA
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