Provider Demographics
NPI:1891044616
Name:ESPRIT DE CORE COUNSELING, INC.
Entity Type:Organization
Organization Name:ESPRIT DE CORE COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHIMP
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:706-782-7194
Mailing Address - Street 1:692 PRIME HILL DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525-4218
Mailing Address - Country:US
Mailing Address - Phone:706-782-7194
Mailing Address - Fax:
Practice Address - Street 1:692 PRIME HILL DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-4218
Practice Address - Country:US
Practice Address - Phone:706-782-7194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0037651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty