Provider Demographics
NPI:1093187049
Name:COUNSELING SERVICES UNITED, LLC
Entity Type:Organization
Organization Name:COUNSELING SERVICES UNITED, LLC
Other - Org Name:CSU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:CLEVELAND
Authorized Official - Last Name:ROWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:470-798-0244
Mailing Address - Street 1:5550 ROSE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-5078
Mailing Address - Country:US
Mailing Address - Phone:678-481-7547
Mailing Address - Fax:678-828-8164
Practice Address - Street 1:132 STANLEY CT
Practice Address - Street 2:SUITE F
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-9061
Practice Address - Country:US
Practice Address - Phone:470-798-0244
Practice Address - Fax:678-828-8164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007296101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003165202AMedicaid