Organization
BROKEN CHAINS INTERNATIONAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN FRANCIS DALY MA, BCPC, BCCC (CEO)
(800) 910-5060
Entity
Organization
Contact information
Practice address
3950 COBB PKWY NW, SUITE 902, ACWORTH, GA 30101-9532
(800) 910-5060
(800) 634-6360
Mailing address
3950 COBB PKWY NW, SUITE 902, ACWORTH, GA 30101-9532
(800) 910-5060
(800) 634-6360
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
001563
GA
101YM0800X
Mental Health Counselor
Primary
09103511
GA
101YP2500X
Professional Counselor
APC003606
GA
101YP2500X
Professional Counselor
LPC007306
GA
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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