Provider Demographics
NPI:1083722250
Name:NORTH GEORGIA COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:NORTH GEORGIA COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTYN
Authorized Official - Middle Name:STREEVER
Authorized Official - Last Name:SNEDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, ACSW
Authorized Official - Phone:706-839-1008
Mailing Address - Street 1:166 COMMERCE PKWY UNIT C
Mailing Address - Street 2:
Mailing Address - City:CORNELIA
Mailing Address - State:GA
Mailing Address - Zip Code:30531-5473
Mailing Address - Country:US
Mailing Address - Phone:706-778-0954
Mailing Address - Fax:833-226-0131
Practice Address - Street 1:166 COMMERCE PKWY UNIT C
Practice Address - Street 2:
Practice Address - City:CORNELIA
Practice Address - State:GA
Practice Address - Zip Code:30531-5473
Practice Address - Country:US
Practice Address - Phone:706-778-0954
Practice Address - Fax:833-226-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW 0012391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000858525BMedicaid
GA000858525BMedicaid