Organization
SAG COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VANESSA ANTIONETTE MACK BS (PARAPROFESSIONAL)
(678) 822-6058
Entity
Organization
Contact information
Practice address
8848 FREEDOM WAY, JONESBORO, GA 30238-4786
(678) 822-6058
Mailing address
8848 FREEDOM WAY, JONESBORO, GA 30238-4786
(678) 822-6058
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
814637459
—
GA
Enumeration date
03/04/2022
Last updated
03/04/2022
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