Organization
CONNECT FOUR COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAWNETTE NICHOLE MILLER LCSW (CLINICAL SOCIAL WORKER - THERAPIST)
(678) 833-1664
Entity
Organization
Contact information
Practice address
2020 AVALON PKWY, SUITE 375, MCDONOUGH, GA 30253-3087
(678) 833-1664
(678) 604-8585
Mailing address
2020 AVALON PKWY, SUITE 375, MCDONOUGH, GA 30253-3087
(678) 833-1664
(678) 604-8585
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSW004801
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003155030A
—
GA
Enumeration date
10/22/2015
Last updated
10/22/2015
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