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General NPI Number Information
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NPI Number | 1376818575
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Entity Type | Organization
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Legal Business Name | NORTH SUBURBAN COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 3516 OLD MILTON PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30005-4458
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Country | US
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Telephone | 678-310-9225
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Fax |
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Provider Business Mailing Address
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Address Line | 300 LIRAC CT
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City | ALPHARETTA
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State | GA
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Zip | 30022-8146
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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 | OWNER
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Name | EMMETT G SHAFFER
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Credential | EDD, LPC
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Telephone | 678-310-9225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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