MEDICARE: REUNITED COUNSELING & TRAINING 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	305R00000X	Preferred Provider Organization		GA

General Provider Information

NPI Number	:	1558550384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REUNITED COUNSELING & TRAINING LLC

Provider Business Mailing Address
First Line	:	143 NEW ST
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-4131
Country	:	US
Telephone Number	:	404-687-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	143 NEW ST
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-4131
Country	:	US
Telephone Number	:	404-687-9188
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. RONALD KEVIN DANCY
Credential	:	M.ED, CADC, CAMS
Telephone Number	:	770-896-4830

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	07/21/2022

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Directions to “REUNITED COUNSELING & TRAINING LLC ” Practice Location

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