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Organization

REVERE COUNSELING AND CARE MANAGEMENT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHANIE LYNN ROACH LCSW (OWNER)
(404) 736-3793
Entity
Organization

Contact information

Practice address
235 E PONCE DE LEON AVE STE 330, DECATUR, GA 30030-3452
(404) 281-5422
Mailing address
235 E PONCE DE LEON AVE STE 330, DECATUR, GA 30030-3452
(404) 281-5422
(404) 377-0750

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW002619
GA

Other

Enumeration date
03/02/2018
Last updated
07/19/2022
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