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:
Map and Directions
Authorized official contact:
Name: Miller, Phyllis Wardrett Licensed Clinical Social Worker (LCSW)
Phone: (404) 626-9690

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902141617 NPPES
Georgia Other 1053692848 INDIVIDUAL NPI
Georgia Other 1750602173 INDIVIDUAL NPI
Georgia MEDICAID 003112377A INDIVIDUAL NPI

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