Organization
COMMUNITY COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARISSA B NAMIRR LPC (PRESIDENT)
(678) 640-1020
Entity
Organization
Contact information
Practice address
3950 COBB PKWY NW, SUITE 708, ACWORTH, GA 30101-9532
(678) 640-1020
Mailing address
3950 COBB PKWY NW, SUITE 708, ACWORTH, GA 30101-9532
(678) 640-1020
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004505
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000000000
APPLIED FOR MEDICAID NUMB
GA
Enumeration date
08/28/2007
Last updated
08/28/2007
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