Organization
AVERETTE CONSULTATION & THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY M AVERETTE-SMITH LCSW, MAC (SOLE PROPRIETOR)
(330) 313-5773
Entity
Organization
Contact information
Practice address
2789 LAKEVIEW WALK, DECATUR, GA 30035-4061
(330) 313-5773
(404) 393-3076
Mailing address
PO BOX 418, AVONDALE ESTATES, GA 30002-0418
(330) 313-5773
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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