Provider Demographics
NPI:1518290857
Name:ACCORDIA COUNSELING SOLUTIONS
Entity Type:Organization
Organization Name:ACCORDIA COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:AYCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-461-9944
Mailing Address - Street 1:115 HABERSHAM DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7353
Mailing Address - Country:US
Mailing Address - Phone:770-461-9944
Mailing Address - Fax:770-461-9779
Practice Address - Street 1:115 HABERSHAM DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7353
Practice Address - Country:US
Practice Address - Phone:770-461-9944
Practice Address - Fax:770-461-9779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002250101YP2500X
GAPSY001928103TC1900X
GACSW0003401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty