Organization
INTEGRATED CONCEPTS FOR FAMILIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KISHA HASSANNA WHITFIELD (CEO)
(770) 703-8502
Entity
Organization
Contact information
Practice address
619 MAIN ST, PALMETTO, GA 30268-1142
(770) 703-8502
(678) 818-4619
Mailing address
619 MAIN ST, PALMETTO, GA 30268-1142
(770) 463-0202
(678) 818-4619
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003127292A
—
GA
Enumeration date
08/09/2011
Last updated
08/10/2016
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