Organization
EMERALD BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY MASON LPC (OWNER)
(478) 331-9624
Entity
Organization
Contact information
Practice address
1205 BELLEVUE AVE, STE B, DUBLIN, GA 31021-4155
(478) 331-9624
Mailing address
1205 BELLEVUE AVE, STE B, DUBLIN, GA 31021-4155
(478) 331-9624
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC 0003624
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003169518A
—
GA
Enumeration date
05/11/2017
Last updated
05/11/2017
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