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Organization
KEY ESSENTIALS COUNSELING AND CONSULTING LLC
Active
Organization
KEY ESSENTIALS COUNSELING AND CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN DUANE LARRY LMSW, LCSW (THERAPIST)
(404) 988-7120
Entity
Organization
Contact information
Practice address
1119 SILVERGATE LN, MABLETON, GA 30126-1273
(404) 542-8787
Mailing address
1119 SILVERGATE LN, MABLETON, GA 30126-1273
(404) 542-8787
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
CSW003802
GA
261QM0850X
Adult Mental Health Clinic/Center
CSW003802
GA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
CSW003802
GA
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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