Provider Demographics
NPI:1225497324
Name:POSITIVE ALTERNATIVES COUNSELING
Entity Type:Organization
Organization Name:POSITIVE ALTERNATIVES COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:912-384-4357
Mailing Address - Street 1:PO BOX 2009
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31534-2009
Mailing Address - Country:US
Mailing Address - Phone:912-384-4357
Mailing Address - Fax:912-384-4356
Practice Address - Street 1:617 WARD ST E
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-0301
Practice Address - Country:US
Practice Address - Phone:912-384-4357
Practice Address - Fax:912-384-4356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004795101YP2500X
AL2520101YP2500X
GALPC007508101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA710145Medicaid