Organization
A CHRISTIAN PLACE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE GAINSBRUGH LPC (OWNER / THERAPIST)
(678) 709-5555
Entity
Organization
Contact information
Practice address
220 LANIER AVE E, FAYETTEVILLE, GA 30214-1604
(678) 709-5555
Mailing address
4109 MERRICK DR, PEACHTREE CITY, GA 30269-6665
(678) 790-9555
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC007774
GA
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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