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General NPI Number Information
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NPI Number | 1396082673
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Entity Type | Organization
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Legal Business Name | LPR COUNSELING SERVICES, INC
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 3013 RAINBOW DR SUITE 112E
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City | DECATUR
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State | GA
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Zip | 30034-1677
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Country | US
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Telephone | 404-553-5457
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Fax | 770-995-1959
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Provider Business Mailing Address
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Address Line | 1436 CATHERINE ST
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City | DECATUR
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State | GA
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Zip | 30030-4505
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Country | US
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Telephone | 404-553-5457
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Fax | 770-995-1959
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Authorized Official
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Title or Position | OWNER
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Name | LINDA ROBINSON
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Credential | LCSW
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Telephone | 404-553-5457
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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 | CSW000427
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License Number State | GA
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