Organization
COUNSELING SERVICES OF LAGRANGE, INC.
Active
Organization
COUNSELING SERVICES OF LAGRANGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON KEITH DUNLAP PHD (OWNER/DIRECTOR)
(706) 884-5050
Entity
Organization
Contact information
Practice address
610 RIDLEY AVE, LAGRANGE, GA 30240-2236
(706) 884-5050
(706) 884-5056
Mailing address
610 RIDLEY AVE, LAGRANGE, GA 30240-2236
(706) 884-5050
(706) 884-5056
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003497
GA
Other
Enumeration date
05/22/2014
Last updated
06/29/2015
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