Organization
CONSCIOUS LIVING COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA FONTAINE LICSW (OWNER)
(256) 221-1137
Entity
Organization
Contact information
Practice address
1302 NOBLE ST STE 2H, ANNISTON, AL 36201-4677
(256) 402-1406
Mailing address
PO BOX 1132, ANNISTON, AL 36202-1132
(256) 403-1406
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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