Organization
KIM CLEVELAND THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA KIM CLEVELAND LPC,CAADC (OWNER)
(229) 483-5050
Entity
Organization
Contact information
Practice address
1511 W 3RD AVE STE 104, ALBANY, GA 31707-3658
(229) 483-5050
(229) 485-1103
Mailing address
1511 W 3RD AVE STE 104, ALBANY, GA 31707-3658
(229) 483-5050
(229) 483-1103
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/13/2020
Last updated
02/04/2021
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