Provider Demographics
NPI:1154067569
Name:DIVENTI COUNSELING LLC
Entity Type:Organization
Organization Name:DIVENTI COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, CPCS, CCM
Authorized Official - Phone:678-532-7415
Mailing Address - Street 1:35 CROSSBILL TRL
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-7658
Mailing Address - Country:US
Mailing Address - Phone:513-225-0279
Mailing Address - Fax:
Practice Address - Street 1:2146 CLARK ST SW
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2231
Practice Address - Country:US
Practice Address - Phone:678-532-7415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty