Organization
RAVEN COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA E CONTON PH.D, LPC (CEO)
(770) 679-4043
Entity
Organization
Contact information
Practice address
867 COMMERCE DR SW, SUITE 200-400, CONYERS, GA 30094-6604
(770) 679-4043
(770) 679-4915
Mailing address
867 COMMERCE DR SW, SUITE 200-400, CONYERS, GA 30094-6604
(770) 679-4043
(770) 679-4915
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC004669
GA
Other
Enumeration date
09/20/2011
Last updated
03/05/2015
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