Organization · Type 2 NPI
Life Intervention Network Center
Mental Health Counselor · Ellenwood, GA
NPI number
1588059232
Active
Practice location
2551 River Forest Ct
Ellenwood, GA 30294-1270
Mailing address
PO Box 360975
Decatur, GA 30036-0975
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
Other mental health counselor providers in Ellenwood
About NPI 1588059232
Life Intervention Network Center's National Provider Identifier is 1588059232, issued on Mar 31, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Ellenwood, GA. The record was last updated on Mar 31, 2015.