PROVIDENCE RESIDENTIAL & OUTPATIENT PTSD SERVICES, LLC

DOUGLASVILLE, GA
NPI1215357272
Doing Business AsPROPS
Entity TypeOrganization
Authorized ContactFELICIA BERRY-MITCHELL
President
770-577-7873
Organization Subpart ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: GA  PSY003237)
Additional Taxonomies101Y00000X Counselor
101YA0400X Counselor, Addiction (Substance Use Disorder)
101YP2500X Counselor, Professional
104100000X Social Worker
1041C0700X Social Worker, Clinical
106H00000X Marriage & Family Therapist
133N00000X Nutritionist
136A00000X Dietetic Technician, Registered
163WP0808X Registered Nurse, Psych/Mental Health
164W00000X Licensed Practical Nurse
171100000X Acupuncturist
171M00000X Case Manager/Care Coordinator
2084P0800X Psychiatry & Neurology, Psychiatry
374700000X Technician
Enumeration Date2014-04-17
Last Update Date2014-04-17
Business Address
PROVIDENCE RESIDENTIAL & OUTPATIENT PTSD SERVICES, LLC
6576 CHURCH ST
DOUGLASVILLE, GA 30134-1884
Phone number: 770-577-7873
Mailing Address
PROVIDENCE RESIDENTIAL & OUTPATIENT PTSD SERVICES, LLC
6576 CHURCH ST
DOUGLASVILLE, GA 30134-1884
Phone number: 770-577-7873