Provider Demographics
NPI:1558550384
Name:REUNITED COUNSELING & TRAINING LLC
Entity Type:Organization
Organization Name:REUNITED COUNSELING & TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:DANCY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CADC, CAMS
Authorized Official - Phone:770-896-4830
Mailing Address - Street 1:143 NEW ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-4131
Mailing Address - Country:US
Mailing Address - Phone:404-687-9188
Mailing Address - Fax:
Practice Address - Street 1:143 NEW ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4131
Practice Address - Country:US
Practice Address - Phone:404-687-9188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization