=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528280740
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STARS COUNSELING SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/03/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1025 VIOLET ST SW
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30310-3748
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-254-6539
-----------------------------------------------------
Fax | 404-420-2325
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1025 VIOLET ST SW
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30310-3748
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-254-6539
-----------------------------------------------------
Fax | 404-420-2325
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER
-----------------------------------------------------
Name | MS. ERICA LATASHA RICHARDSON
-----------------------------------------------------
Credential | LAPC
-----------------------------------------------------
Telephone | 770-598-2850
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------