Provider Demographics
NPI:1164737862
Name:NORTH GEORGIA COUNSELING AND EDUCATION CENTER
Entity Type:Organization
Organization Name:NORTH GEORGIA COUNSELING AND EDUCATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSTRUCTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PENNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-867-6798
Mailing Address - Street 1:431 GROVE ST N
Mailing Address - Street 2:SUITE E
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-0437
Mailing Address - Country:US
Mailing Address - Phone:706-867-6798
Mailing Address - Fax:706-867-0265
Practice Address - Street 1:431 GROVE ST N
Practice Address - Street 2:SUITE E
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-0437
Practice Address - Country:US
Practice Address - Phone:706-867-6798
Practice Address - Fax:706-867-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6735252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency