Organization
PROVIDENCE COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MULLIGAN LCSW (OWNER)
(808) 248-5153
Entity
Organization
Contact information
Practice address
1301 SHILOH RD NW, STE 840, KENNESAW, GA 30144-7147
(678) 942-1115
Mailing address
3626 STEINHAUER RD NE, MARIETTA, GA 30066-4755
(678) 248-5153
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/12/2016
Last updated
06/12/2016
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