Connect Four Counseling Llc | |
2020 Avalon Pkwy Suite 375 Mcdonough GA 30253-3087 | |
(678) 833-1664 | |
(678) 604-8585 |
Full Name | Connect Four Counseling Llc |
---|---|
Speciality | Community/behavioral Health |
Location | 2020 Avalon Pkwy, Mcdonough, Georgia |
Authorized Official Name and Position | Shawnette Nichole Miller (CLINICAL SOCIAL WORKER - THERAPIST) |
Authorized Official Contact | 6788331664 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Connect Four Counseling Llc 2020 Avalon Pkwy Suite 375 Mcdonough GA 30253-3087 Ph: (678) 833-1664 | Connect Four Counseling Llc 2020 Avalon Pkwy Suite 375 Mcdonough GA 30253-3087 Ph: (678) 833-1664 |
NPI Number | 1083086581 |
---|---|
Provider Enumeration Date | 10/22/2015 |
Last Update Date | 10/22/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083086581 | NPI | - | NPPES |
003155030A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | CSW004801 (Georgia) | Primary |
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