Organization
RADANDEL COMMUNITY COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLA MICHELLE STEPHENSON RN (ADMINISTRATOR)
(470) 545-0860
Entity
Organization
Contact information
Practice address
1315 MILSTEAD RD NE, CONYERS, GA 30012-3824
(470) 545-0860
(470) 300-7778
Mailing address
1315 MILSTEAD RD NE, CONYERS, GA 30012-3824
(470) 545-0860
(470) 300-7778
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2800X
Methadone Clinic
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003218438A
—
GA
Enumeration date
08/17/2020
Last updated
04/09/2026
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