Provider Demographics
NPI:1669822425
Name:PARACLETE COUNSELING AND COACHING
Entity Type:Organization
Organization Name:PARACLETE COUNSELING AND COACHING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC/CAMS
Authorized Official - Phone:803-270-0624
Mailing Address - Street 1:2226 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-2010
Mailing Address - Country:US
Mailing Address - Phone:803-270-0624
Mailing Address - Fax:
Practice Address - Street 1:2226 PEACH ORCHARD RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-2010
Practice Address - Country:US
Practice Address - Phone:803-270-0624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008705251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health