Organization
INTEGRATED COUNSELING CENTER & CONSULTING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA KROW M.S., LPC (OWNER)
(404) 610-1434
Entity
Organization
Contact information
Practice address
3400 CHAPEL HILL RD, STE 100 PMB# 16, DOUGLASVILLE, GA 30135
(404) 610-1434
Mailing address
3400 CHAPEL HILL RD, STE 100 PMB# 16, DOUGLASVILLE, GA 30135
(404) 610-1434
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
LPC008185
GA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LPC008185
GA
261QM0850X
Adult Mental Health Clinic/Center
LPC008185
GA
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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