Provider Demographics
NPI:1518350081
Name:COGNITIVE COUNSELING CONSULTANTS OF GEORGIA
Entity Type:Organization
Organization Name:COGNITIVE COUNSELING CONSULTANTS OF GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LAPC
Authorized Official - Phone:404-825-4241
Mailing Address - Street 1:5745 N CASTLEGATE DR APT C
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5283
Mailing Address - Country:US
Mailing Address - Phone:404-825-4241
Mailing Address - Fax:404-669-0222
Practice Address - Street 1:5745 N CASTLEGATE DR APT C
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-5283
Practice Address - Country:US
Practice Address - Phone:404-825-4241
Practice Address - Fax:404-669-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA311464251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health