Crossroads Church Of Douglasville
Social Worker, Clinical in Douglasville, GA. Organization (NPI-2).
NPI number1265838544
StatusActive
Last updated in NPPESNov 13, 2014
Details
- NPI
- 1265838544
- Entity type
- Organization (NPI-2)
- Legal business name
- Crossroads Church Of Douglasville
- Organization subpart
- No
- Enumeration date
- Nov 13, 2014
- Last updated
- Nov 13, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | CSW005316 | GA | Yes |
| 101YP2500X | Counselor, Professional | LPC003962 | GA |
Practice location
5960 Stewart PkwyDouglasville, GA 30135-2372
Phone 404-996-0170
Mailing address
5960 Stewart PkwyDouglasville, GA 30135-2372
Phone 404-996-0170
Authorized official
Justin McKinney
Director Of Counseling
4049960170
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