Provider Demographics
NPI:1164874509
Name:CHANDRA ALBRITTON COUNSELING SERVICES
Entity Type:Organization
Organization Name:CHANDRA ALBRITTON COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ALBRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:LAPC
Authorized Official - Phone:478-832-2746
Mailing Address - Street 1:152 NEW ST
Mailing Address - Street 2:SUITE 109B
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-7304
Mailing Address - Country:US
Mailing Address - Phone:478-832-2746
Mailing Address - Fax:
Practice Address - Street 1:152 NEW ST
Practice Address - Street 2:SUITE 109B
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-7304
Practice Address - Country:US
Practice Address - Phone:478-832-2746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC004505251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health