Provider Demographics
NPI:1245748771
Name:EMANUEL COUNSELING SERVICES, INC
Entity Type:Organization
Organization Name:EMANUEL COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:478-289-8147
Mailing Address - Street 1:105 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3645
Mailing Address - Country:US
Mailing Address - Phone:478-289-8147
Mailing Address - Fax:478-289-8148
Practice Address - Street 1:105 WARREN AVE
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3645
Practice Address - Country:US
Practice Address - Phone:478-289-8147
Practice Address - Fax:478-289-8148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA36774207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty