Revival Counseling Services Incorporated

LBN: Revival Counseling Services Incorporated
Revival Counseling Services Incorporated is an health care organization with primary practice located at 5357 Chapel Hill Rd , Douglasville GA 30135-5027. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Revival Counseling Services Incorporated can be contacted via phone (770) 942-4742, or through Bonich, Danielle via phone (678) 656-8249.

Contact Information

Primary practice address
5357 Chapel Hill Rd Douglasville GA 30135-5027
Fax:
Website:
Authorized official contact:
Name: Bonich, Danielle Licensed Clinical Social Worker (LCSW)

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1831647213
LBN Legal business name Revival Counseling Services Incorporated
DBA Doing business as
Authorized official Bonich, Danielle Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 14th, 2016
Last updated Sep 14th, 2016 - 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1831647213 NPPES
Georgia Other 4829878 CIGNA

Popular Providers