Provider Demographics
NPI:1861022063
Name:CARRICK COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:CARRICK COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRICK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-242-3395
Mailing Address - Street 1:1604 BRIARCLIFF RD NE UNIT 6
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306
Mailing Address - Country:US
Mailing Address - Phone:404-242-3395
Mailing Address - Fax:
Practice Address - Street 1:235 E PONCE DE LEON AVE STE 120
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3412
Practice Address - Country:US
Practice Address - Phone:404-242-3395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty