Provider Demographics
NPI:1689246654
Name:COUNSELOR'S OFFICE
Entity Type:Organization
Organization Name:COUNSELOR'S OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:LILA
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:912-353-7699
Mailing Address - Street 1:9 HETHERINGTON LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-1527
Mailing Address - Country:US
Mailing Address - Phone:912-353-7699
Mailing Address - Fax:912-353-9879
Practice Address - Street 1:107 OGLETHORPE PROFESSIONAL CT
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3623
Practice Address - Country:US
Practice Address - Phone:912-353-7699
Practice Address - Fax:912-353-9879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-10
Last Update Date:2021-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty