Organization
COBB DOUGLAS COMMUNITY SERVICES BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN STEPHENS LPC (INTERIM CEO)
(770) 429-5000
Entity
Organization
Contact information
Practice address
331 N MARIETTA PKWY NE, MARIETTA, GA 30060-1457
(770) 499-2422
Mailing address
331 N MARIETTA PKWY NE, MARIETTA, GA 30060-1457
(770) 499-2422
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002215
GA
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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