Organization
MCINTOSH TRAIL COMMUNITY SERVICE BOARD
Active
Other names
Fayette Co Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENYATTA DENISE WALKER LCSW (CEO)
(770) 358-5252
Entity
Organization
Contact information
Practice address
245 BOOKER AVE, SUITE F, FAYETTEVILLE, GA 30215
(770) 358-5252
(770) 229-3223
Mailing address
1435 NORTH EXPRESSWAY SUITE 301, GRIFFIN, GA 30223
(770) 358-5252
(770) 229-3223
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000601609M
—
GA
Enumeration date
02/08/2008
Last updated
06/23/2025
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