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General NPI Number Information
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NPI Number | 1295108140
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Entity Type | Organization
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Legal Business Name | COUNSELING CRISIS AND CARING, LLC
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Dates
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Enumeration Date | 10/31/2015
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Last Update Date | 10/31/2015
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Provider Practice Location Address
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Address Line | 3330 CUMBERLAND BLVD SE STE 500
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City | ATLANTA
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State | GA
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Zip | 30339-5997
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Country | US
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Telephone | 770-933-6222
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Fax | 404-228-6597
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Provider Business Mailing Address
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Address Line | 3330 CUMBERLAND BLVD SE STE 500
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City | ATLANTA
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State | GA
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Zip | 30339-5997
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Country | US
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Telephone | 770-933-6222
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Fax | 404-228-6597
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Authorized Official
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Title or Position | CEO
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Name | CRESTRE MERITA BODDY
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Credential | MSW
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Telephone | 770-310-3257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 15015001
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License Number State | GA
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