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General NPI Number Information
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NPI Number | 1285252338
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Entity Type | Organization
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Legal Business Name | SENSE OF EQUITY PROGRAMDEVELOPMENT TRAINING&ACCREDITATION SERVICES LLC
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 1 W COURT SQ STE 750
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City | DECATUR
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State | GA
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Zip | 30030-2545
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Country | US
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Telephone | 404-955-7198
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 784
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City | LITHONIA
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State | GA
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Zip | 30058-0784
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Country | US
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Telephone | 678-232-2765
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVINE S RICKS
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Credential | LCSW, MAC, E-CADC
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Telephone | 678-232-2765
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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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