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Organization
BRIDGING SEVENTEEN COUNSELING CENTER, LLC
Active
Organization
BRIDGING SEVENTEEN COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRI VERNESE JENKINS ED.D, LPC, NCC, ACS (EXECUTIVE DIRECTOR)
(706) 496-1010
Entity
Organization
Contact information
Practice address
3108 PEACH ORCHARD RD #6419, AUGUSTA, GA 30909-3090
(706) 496-1010
(877) 496-4637
Mailing address
4157 ELDERS DR, AUGUSTA, GA 30909-9145
(706) 496-1010
(877) 496-4637
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
LPC006595
GA
261QM0850X
Adult Mental Health Clinic/Center
LPC006595
GA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
LPC006595
GA
Other
Enumeration date
06/22/2017
Last updated
06/22/2017
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