MEDICARE: CARE COUNSELING OF GEORGIA

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	LPC005328	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225427537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE COUNSELING OF GEORGIA

Provider Business Mailing Address
First Line	:	76 MILLENNIUM CIR
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-2775
Country	:	US
Telephone Number	:	706-935-5000
Fax Number	:	706-410-2273

Provider Business Practice Location Address
First Line	:	76 MILLENNIUM CIR
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-2775
Country	:	US
Telephone Number	:	706-935-5000
Fax Number	:	706-410-2273

Authorized Official
Title or Position	:	COUNSELOR
Name	:	KIMBALI TAYLOR
Credential	:
Telephone Number	:	423-991-0494

Provider Enumeration Date	:	01/10/2015
Last Update Date	:	01/10/2015

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