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Organization

INTERCEPTION COUNSELING SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GEORGE WASHINGTON KELLY MA, LPC (PROFESSIONAL COUNSELOR)
(520) 261-0608
Entity
Organization

Contact information

Practice address
40 N SWAN RD STE 114, TUCSON, AZ 85711-3019
(520) 261-0608
(520) 422-4911
Mailing address
5555 S WHITE SPAR TRL, TUCSON, AZ 85747-0012
(520) 429-6129

Taxonomy

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

Other

Enumeration date
03/04/2020
Last updated
10/19/2020
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