| NPI | 1124425160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XAVIER MARQUIS MCCASKEY Partner 706-536-7287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW005312) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC007918) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA LPC007918) | |
| 101YM0800X Counselor Mental Health (Licence: GA LPC007918) | |
| 101YP2500X Counselor Professional (Licence: GA LPC007918) | |
| 104100000X Social Worker (Licence: GA CSW005312) | |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2014-11-19 |