Organization
BRANDON A COUSSENS LMFT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON A COUSSENS LMFT (CEO)
(478) 335-4743
Entity
Organization
Contact information
Practice address
654 MAIN ST, STE 6, THOMSON, GA 30824-7403
(706) 595-2548
Mailing address
PO BOX 22, LINCOLNTON, GA 30817-0022
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFT001247
GA
Other
Enumeration date
03/08/2013
Last updated
03/08/2013
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