Organization
ATHENS COUNSELING & PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIELLE ANGELA STAIR LCSW (OWNER/OPERATOR)
(706) 514-1213
Entity
Organization
Contact information
Practice address
1 HUNTINGTON RD STE 101, ATHENS, GA 30606-7205
(706) 514-1213
(706) 504-9549
Mailing address
1 HUNTINGTON RD STE 101, ATHENS, GA 30606-7205
(706) 514-1213
(706) 504-9549
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW006527
GA BOARD OF PROF. COUNSELORS, SOCIAL WORKERS, AND MARRIAGE & FAMILY THERAPISTS
GA
Enumeration date
12/07/2018
Last updated
12/31/2019
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