Provider Demographics
NPI:1861645376
Name:FAMILY COUNSELING ASSOCIATES OF NORTH GEORGIA LLC
Entity Type:Organization
Organization Name:FAMILY COUNSELING ASSOCIATES OF NORTH GEORGIA LLC
Other - Org Name:FAMILY COUNSELING ASSOCIATES OF NORTH GEORGIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:SLAUGHTER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD,LPC,RPT
Authorized Official - Phone:706-265-8224
Mailing Address - Street 1:3615 HUTCHINSON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-0500
Mailing Address - Country:US
Mailing Address - Phone:706-265-8224
Mailing Address - Fax:888-447-9197
Practice Address - Street 1:3615 HUTCHINSON RD STE 102
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-0500
Practice Address - Country:US
Practice Address - Phone:706-265-8224
Practice Address - Fax:888-447-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004935101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty