Provider Demographics
NPI:1942533377
Name:DIVERSE COUNSELING & PSYCHOLOGICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DIVERSE COUNSELING & PSYCHOLOGICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SIGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-869-9474
Mailing Address - Street 1:2941 PIEDMONT RD NE
Mailing Address - Street 2:SUITE F
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2784
Mailing Address - Country:US
Mailing Address - Phone:404-869-9474
Mailing Address - Fax:404-869-6421
Practice Address - Street 1:2941 PIEDMONT RD NE
Practice Address - Street 2:SUITE F
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2784
Practice Address - Country:US
Practice Address - Phone:404-869-9474
Practice Address - Fax:404-869-6421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002740103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty