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General NPI Number Information
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NPI Number | 1952606899
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Entity Type | Organization
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Legal Business Name | MORNINGSTAR CHRISTIAN COUNSELING CENTER
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 7712 HAMPTON PL
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City | LOGANVILLE
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State | GA
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Zip | 30052-6770
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Country | US
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Telephone | 770-554-3110
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Fax | 678-635-5354
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Provider Business Mailing Address
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Address Line | 7712 HAMPTON PL
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City | LOGANVILLE
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State | GA
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Zip | 30052-6770
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Country | US
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Telephone | 770-554-3110
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Fax | 678-635-5354
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Authorized Official
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Title or Position | PASTORAL COUNSELOR
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Name | CAROLYN SMITH
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Credential | MA
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Telephone | 770-554-3110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 10076 NCCA LICENSE
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License Number State | GA
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