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General NPI Number Information
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NPI Number | 1427765858
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Entity Type | Organization
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Legal Business Name | CHARIS COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 387 GROVE ST N STE C
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City | DAHLONEGA
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State | GA
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Zip | 30533-0457
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Country | US
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Telephone | 706-482-0073
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MEMORY LN
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City | DAHLONEGA
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State | GA
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Zip | 30533-4091
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Country | US
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Telephone | 706-482-0073
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | KELLY CRISSON
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Credential | MA
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Telephone | 706-482-0073
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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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