Provider Demographics
NPI:1295108140
Name:COUNSELING CRISIS AND CARING, LLC
Entity type:Organization
Organization Name:COUNSELING CRISIS AND CARING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRESTRE
Authorized Official - Middle Name:MERITA
Authorized Official - Last Name:BODDY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:770-310-3257
Mailing Address - Street 1:3330 CUMBERLAND BLVD SE STE 500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5997
Mailing Address - Country:US
Mailing Address - Phone:770-933-6222
Mailing Address - Fax:404-228-6597
Practice Address - Street 1:3330 CUMBERLAND BLVD SE STE 500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5997
Practice Address - Country:US
Practice Address - Phone:770-933-6222
Practice Address - Fax:404-228-6597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-31
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15015001302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization