Fayette Co Counseling Center
LBN: Mcintosh Trail Csb
Fayette Co Counseling Center is an health care organization with primary practice located at 715 Bradley Dr , Fayetteville GA 30214-2030. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty.
Mcintosh Trail Csb can be contacted via phone (770) 460-2460, or through Hubbard, Mike via phone (770) 358-8251.
Contact Information
Primary practice address
715 Bradley Dr
Fayetteville GA 30214-2030
Phone: (770) 460-2460
Fax:
Website:
Authorized official contact:
Name: Hubbard, Mike Licensed Clinical Social Worker (LCSW)
Phone: (770) 358-8251
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Community/Behavioral Health | 251S00000X |
Profile Details
| NPI number | 1689852840 |
|---|---|
| LBN Legal business name | Mcintosh Trail Csb |
| DBA Doing business as | Fayette Co Counseling Center |
| Authorized official | Hubbard, Mike Licensed Clinical Social Worker (LCSW) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 8th, 2008 |
| Last updated | Dec 17th, 2015 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689852840 | NPPES |
| Georgia | MEDICAID | 000601609M |
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