Provider Demographics
NPI:1184844565
Name:REDIRECT COUNSELING SERVICES INC
Entity Type:Organization
Organization Name:REDIRECT COUNSELING SERVICES INC
Other - Org Name:REDIRECT DRIVER IMPROVEMENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:ICADC, CCS
Authorized Official - Phone:229-293-0444
Mailing Address - Street 1:2031 A BEMISS ROAD
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602
Mailing Address - Country:US
Mailing Address - Phone:229-293-0444
Mailing Address - Fax:229-253-0381
Practice Address - Street 1:2031 BEMISS RD # A
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-3030
Practice Address - Country:US
Practice Address - Phone:229-293-0444
Practice Address - Fax:229-253-0381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA26001261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA9140OtherRISK REDUCTION PROGRAM
GA26001OtherLEVEL ONE