Organization
UNLEASHED POTENTIAL COUNSELING AND SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY MACK LPC (EXECUTIVE DIRECTOR)
(706) 394-4357
Entity
Organization
Contact information
Practice address
4729 QUAKER RD, ADMINISTRATION SUITE, KEYSVILLE, GA 30816-4950
(706) 836-7873
(706) 595-3070
Mailing address
4729 QUAKER RD, ADMINISTRATION SUITE, KEYSVILLE, GA 30816-4950
(706) 836-7873
(706) 595-3070
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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