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General NPI Number Information
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NPI Number | 1427624428
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Entity Type | Organization
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Legal Business Name | RECOVERY & CONSULTING THROUGH A DIFFERENT LENS
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Dates
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Enumeration Date | 06/01/2021
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 1311 PEBBLE RIDGE LN
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City | HAMPTON
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State | GA
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Zip | 30228-6121
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Country | US
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Telephone | 470-219-4855
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Fax |
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Provider Business Mailing Address
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Address Line | 3863 GA-138 PMB 535
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City | STOCKBRIDGE
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State | GA
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Zip | 30281
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Country | US
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Telephone | 470-651-6704
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Fax | 844-492-1148
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Authorized Official
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Title or Position | FOUNDER
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Name | SUSANAH DESILVA
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Credential | LCSW
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Telephone | 470-651-6704
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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