Organization
PROVISION COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEMIKA ROACH (LPC/OWNER)
(478) 414-1946
Entity
Organization
Contact information
Practice address
1776 N JEFFERSON ST NE STE B, MILLEDGEVILLE, GA 31061-2292
(478) 414-1946
(866) 815-6940
Mailing address
1776 N JEFFERSON ST NE STE B, MILLEDGEVILLE, GA 31061-2292
(478) 414-1946
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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