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General NPI Number Information
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NPI Number | 1679114201
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Entity Type | Organization
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Legal Business Name | ENGLAND COUNSELING AND BEHAVIORAL SERVICES LLC
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Dates
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Enumeration Date | 10/04/2019
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 2150 ELDER MILL RD
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City | WATKINSVILLE
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State | GA
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Zip | 30677-3300
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Country | US
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Telephone | 706-476-8073
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Fax | 770-995-1959
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Provider Business Mailing Address
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Address Line | 2150 ELDER MILL RD
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City | WATKINSVILLE
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State | GA
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Zip | 30677-3300
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Country | US
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Telephone | 706-476-8073
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Fax | 770-995-1959
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | LYNETTE CLARK
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Credential |
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Telephone | 770-339-7667
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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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