Organization
SECOND CHANCE OR MORE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NINA A. WHITE PHD, LPC,LMHC,MFT (DIRECTOR/OWNER)
(407) 462-5483
Entity
Organization
Contact information
Practice address
110 EVANS MILL DR, SUITE 401, DALLAS, GA 30157-1622
(407) 462-5483
Mailing address
PO BOX 1018, HIRAM, GA 30141-1018
(407) 462-5483
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC007084
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00313130
—
GA
Enumeration date
01/05/2017
Last updated
01/05/2017
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