Organization
AR PSYCHIATRIC & COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANIL KUMAR GUPTA M.D. (OWNER)
(229) 244-2030
Entity
Organization
Contact information
Practice address
3312 N OAK ST EXT BLDG D, VALDOSTA, GA 31605-1066
(229) 244-2030
(229) 244-2038
Mailing address
3312 N OAK ST EXT BLDG D, VALDOSTA, GA 31605-1066
(229) 244-2030
(229) 244-2038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00934975E
—
GA
Enumeration date
04/14/2011
Last updated
09/08/2020
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