Provider Demographics
NPI:1598226656
Name:OCONEE FAMILY COUNSELING, LLC
Entity Type:Organization
Organization Name:OCONEE FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-363-3352
Mailing Address - Street 1:1160 RIVER RUN
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:GA
Mailing Address - Zip Code:30621-1665
Mailing Address - Country:US
Mailing Address - Phone:706-363-3352
Mailing Address - Fax:
Practice Address - Street 1:485 HUNTINGTON RD STE 196
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-1845
Practice Address - Country:US
Practice Address - Phone:706-363-3352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty