Provider Demographics
NPI:1215182555
Name:EMANUEL COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:EMANUEL COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:478-289-8147
Mailing Address - Street 1:247 W MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3163
Mailing Address - Country:US
Mailing Address - Phone:478-289-8147
Mailing Address - Fax:
Practice Address - Street 1:247 W MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3163
Practice Address - Country:US
Practice Address - Phone:478-289-8147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty