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Organization
RTD WELLNESS AND BEHAVIORAL SERVICES
Active
Organization
RTD WELLNESS AND BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIREA RUSSELL MS, LPC (CFO/OWNER)
(678) 709-8002
Entity
Organization
Contact information
Practice address
2001 MARTIN LUTHER KING JR DR SW STE 201, ATLANTA, GA 30310-1101
(404) 476-5498
Mailing address
2290 LAKE ROYALE DR, RIVERDALE, GA 30296-1896
(678) 709-8002
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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