Provider Demographics
NPI:1629852272
Name:COUNSELING 360, LLC
Entity Type:Organization
Organization Name:COUNSELING 360, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CURLISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CREIGHTON-MUWAKKIL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-632-4004
Mailing Address - Street 1:3244 SHAMROCK CT
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-7132
Mailing Address - Country:US
Mailing Address - Phone:810-869-6294
Mailing Address - Fax:
Practice Address - Street 1:3244 SHAMROCK CT
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-7132
Practice Address - Country:US
Practice Address - Phone:810-869-6294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251B00000XAgenciesCase Management