Provider Demographics
NPI:1184957284
Name:RESOLVE COUNSELING SERVICES
Entity type:Organization
Organization Name:RESOLVE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROYSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MA
Authorized Official - Phone:770-330-3418
Mailing Address - Street 1:4024 TURNSTONE DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-6420
Mailing Address - Country:US
Mailing Address - Phone:770-330-3418
Mailing Address - Fax:
Practice Address - Street 1:3459 ACWORTH DUE WEST RD NW
Practice Address - Street 2:SUITE 565
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-5819
Practice Address - Country:US
Practice Address - Phone:770-330-3418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC050099251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA470676644AMedicaid