Organization
SOURCE OF STRENGTH PROFESSIONAL COUNSELING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATRINA GRAHAM LPC, NCC (OWNER/CEO)
(404) 272-3436
Entity
Organization
Contact information
Practice address
821 PAVILION CT, SUITE A, MCDONOUGH, GA 30253-5222
(404) 272-3436
(404) 855-2887
Mailing address
2890 HIGHWAY 212 SW, SUITE A-289, CONYERS, GA 30094-3363
(404) 272-3436
(404) 855-2887
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC006099
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003133448A
—
GA
05
—
003133452A
—
GA
Enumeration date
08/11/2013
Last updated
09/15/2013
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