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Organization

PANACEA COUNSELING SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PATRICE LATONYA COX MA, LPC (CO-FOUNDER/THERAPIST)
(404) 936-3126
Entity
Organization

Contact information

Practice address
5436 GLEN HAVEN DR, COLLEGE PARK, GA 30349-6481
(404) 936-3126
(404) 601-7530
Mailing address
1436 KING RD, RIVERDALE, GA 30296-2915
(404) 936-3126
(404) 601-7530

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC005841
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YM0800X
GA
Enumeration date
01/13/2010
Last updated
01/13/2010
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