Organization
MODERN FAMILY COUNSELING
Active
Organization
MODERN FAMILY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE HICKS (OWNER)
(404) 409-4945
Entity
Organization
Contact information
Practice address
3387 E FIRST ST, BLUE RIDGE, GA 30513-7115
(404) 409-4945
(866) 789-4966
Mailing address
3387 E FIRST ST, BLUE RIDGE, GA 30513-7115
(404) 409-4945
(866) 789-4966
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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