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Organization

THE PROGRESSIVE COUNSELING AND THERAPY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIE JAMES CAMPBELL SR. LCSW (DIRECTOR)
(678) 592-9454
Entity
Organization

Contact information

Practice address
101 DEVANT ST, SUITE 606, FAYETTEVILLE, GA 30214-2710
(678) 592-9454
Mailing address
101 DEVANT ST, SUITE 606, FAYETTEVILLE, GA 30214-2710
(678) 592-9454

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSW004685
GA

Other

Enumeration date
07/04/2012
Last updated
10/02/2013
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