Tidwell& Miller Counseling Services, Llc
LBN: Tidwell& Miller Counseling Services, Llc
Tidwell& Miller Counseling Services, Llc is an health care organization with primary practice located at 215 Church St Ste 105 , Decatur GA 30030-3330. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty.
Tidwell& Miller Counseling Services, Llc can be contacted via phone (404) 626-9690, or through Miller, Phyllis Wardrett via phone (404) 626-9690.
Contact Information
Primary practice address
215 Church St Ste 105
Decatur GA 30030-3330
Phone: (404) 626-9690
Fax: (770) 808-9273
Website:
Authorized official contact:
Name: Miller, Phyllis Wardrett Licensed Clinical Social Worker (LCSW)
Phone: (404) 626-9690
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW000649 | Georgia |
Profile Details
| NPI number | 1902141617 |
|---|---|
| LBN Legal business name | Tidwell& Miller Counseling Services, Llc |
| DBA Doing business as | |
| Authorized official | Miller, Phyllis Wardrett Licensed Clinical Social Worker (LCSW) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 6th, 2012 |
| Last updated | Dec 6th, 2012 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902141617 | NPPES |
| Georgia | Other | 1053692848 | INDIVIDUAL NPI |
| Georgia | Other | 1750602173 | INDIVIDUAL NPI |
| Georgia | MEDICAID | 003112377A | INDIVIDUAL NPI |
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