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Organization

BLUE RIDGE COUNSELING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSEPH MITCHELL STAPP MA, LPC, NCC (PRESIDENT/OWNER)
(706) 974-3899
Entity
Organization

Contact information

Practice address
76 SANDCASTLE COURT, DAWSONVILLE, GA 30534-7075
(706) 974-3899
(866) 242-0878
Mailing address
PO BOX 2017, DAWSONVILLE, GA 30534-0036
(706) 974-3899

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004711
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11968290
CAQH/GUHP PROVIDER IDENTIFICATION NUMBER
GA
05
847805426B
GA
Enumeration date
03/27/2009
Last updated
11/30/2011
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