Provider Demographics
NPI:1336315811
Name:AFFINITY COUNSELING CENTER
Entity Type:Organization
Organization Name:AFFINITY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:T
Authorized Official - Last Name:TIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-464-4990
Mailing Address - Street 1:3883 ROGERS BRIDGE RD STE 204A
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2803
Mailing Address - Country:US
Mailing Address - Phone:678-392-1302
Mailing Address - Fax:877-505-5278
Practice Address - Street 1:3883 ROGERS BRIDGE RD STE 204A
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-2803
Practice Address - Country:US
Practice Address - Phone:678-392-1302
Practice Address - Fax:877-505-5278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004752101YP2500X
GAAPC000947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty