Provider Demographics
NPI:1235887589
Name:FOUR THIRTEEN COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:FOUR THIRTEEN COUNSELING SERVICES, LLC
Other - Org Name:FOUR THIRTEEN COUNSELING SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:205-240-0498
Mailing Address - Street 1:PO BOX 8224
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-8224
Mailing Address - Country:US
Mailing Address - Phone:205-690-0651
Mailing Address - Fax:
Practice Address - Street 1:3059 EDGEWOOD CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-2593
Practice Address - Country:US
Practice Address - Phone:205-240-0498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health