Organization
CROSSROADS CHURCH OF DOUGLASVILLE
Active
Organization
CROSSROADS CHURCH OF DOUGLASVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN MCKINNEY L.C.S.W. (DIRECTOR OF COUNSELING)
(404) 996-0170
Entity
Organization
Contact information
Practice address
5960 STEWART PKWY, DOUGLASVILLE, GA 30135-2372
(404) 996-0170
Mailing address
5960 STEWART PKWY, DOUGLASVILLE, GA 30135-2372
(404) 996-0170
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC003962
GA
1041C0700X
Clinical Social Worker
Primary
CSW005316
GA
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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