Organization
EXPANSION COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EBONI R MORMANT LPC, CPCS (DIRECTOR)
(770) 910-9162
Entity
Organization
Contact information
Practice address
500 SUN VALLEY DRIVE D2, ROSWELL, GA 30076
(770) 910-9162
(770) 910-9768
Mailing address
500 SUN VALLEY DRIVE D2, ROSWELL, GA 30076
(770) 910-9162
(770) 910-9768
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
106S00000X
Behavior Technician
—
—
163WC1500X
Community Health Registered Nurse
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
251S00000X
Community/Behavioral Health Agency
1184963357
GA
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003275832A
—
GA
01
—
1720539562
GROUP NPI
GA
Enumeration date
10/17/2016
Last updated
07/05/2023
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