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General NPI Number Information
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NPI Number | 1962042812
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Entity Type | Organization
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Legal Business Name | BE EPIC COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 323 PINE AVE STE 114
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City | ALBANY
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State | GA
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Zip | 31701-2575
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Country | US
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Telephone | 229-886-3694
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Fax | 866-208-0960
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Provider Business Mailing Address
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Address Line | 323 PINE AVE STE 114
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City | ALBANY
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State | GA
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Zip | 31701-2575
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Country | US
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Telephone | 229-886-3694
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Fax | 866-208-0960
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Authorized Official
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Title or Position | OWNER
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Name | TEQUILLA PITTMAN
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Credential |
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Telephone | 229-886-3694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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