Organization
PORT COUNSELING & CONSULTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA CAMPBELL LCSW (DIRECTOR)
(678) 382-3187
Entity
Organization
Contact information
Practice address
2000 RIVEREDGE PKWY, STE 885, ATLANTA, GA 30328-4694
(678) 382-3187
Mailing address
2346 KINGS POINT DR, DUNWOODY, GA 30338-5925
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/22/2016
Last updated
02/22/2016
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