MEDICARE: PRIVACY FIRST COUNSELING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC003892	GA

General Provider Information

NPI Number	:	1225231814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIVACY FIRST COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	3714 WOODLAKE RD
Second Line	:
City	:	HEPHZIBAH
State	:	GA
Zip	:	30815-6560
Country	:	US
Telephone Number	:	706-790-7948
Fax Number	:	706-790-7948

Provider Business Practice Location Address
First Line	:	3114 AUGUSTA TECH DR
Second Line	:	SUITE 203
City	:	AUGUSTA
State	:	GA
Zip	:	30906-3300
Country	:	US
Telephone Number	:	706-790-6434
Fax Number	:	706-790-7948

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	DR. JOHN ALBERTY
Credential	:
Telephone Number	:	706-790-6434

Provider Enumeration Date	:	06/09/2007
Last Update Date	:	08/22/2020

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