Individual provider · Type 1 NPI
Elian Gomez Azcarate Renero, COMMUNITY SUPPORT IN
Mental Health Counselor · Lilburn, GA
NPI number
1215651385
Active
Practice location
1113 Staples Dr SW
Lilburn, GA 30047-2385
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker | 1041C0700X | None listed |
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1215651385
Elian Gomez Azcarate Renero, COMMUNITY SUPPORT IN's National Provider Identifier is 1215651385, issued on Oct 3, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lilburn, GA. The record was last updated on Oct 3, 2022.