# MARIETTA COUNSELING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598216061
- **Authorized official:** DANIELLE M TIDWELL MFT (THERAPIST)
- **Authorized official phone:** (678) 677-7484

## Contact information

- **Practice address:** 2440 SANDY PLAINS RD, BLDG \#25, MARIETTA, GA 30066-7217
- **Practice address phone:** (770) 971-9311
- **Mailing address:** 2440 SANDY PLAINS RD, BLDG \#25, MARIETTA, GA 30066-7217
- **Mailing address phone:** (770) 971-9311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | NOT ISSUED YET | GA | Yes |

## Other

- **Enumeration date:** 10/20/2016
- **Last updated:** 10/20/2016