Provider Demographics
NPI:1841791944
Name:VIPP COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:VIPP COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERNETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAILEY-WORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-514-4833
Mailing Address - Street 1:902 COMMERCIAL ST NE STE 203
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-4553
Mailing Address - Country:US
Mailing Address - Phone:404-514-4833
Mailing Address - Fax:770-679-5368
Practice Address - Street 1:903 COMMERCIAL ST NE STE 203
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-4553
Practice Address - Country:US
Practice Address - Phone:404-514-4833
Practice Address - Fax:770-679-5368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009297101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty