Provider Demographics
NPI:1336773050
Name:INVESTED CARE COUNSELING SERVICES
Entity Type:Organization
Organization Name:INVESTED CARE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATISHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS- MCJUNKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MAC
Authorized Official - Phone:917-804-5250
Mailing Address - Street 1:120 TUSCANY CT
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-4089
Mailing Address - Country:US
Mailing Address - Phone:917-804-5250
Mailing Address - Fax:
Practice Address - Street 1:120 TUSCANY CT
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-4089
Practice Address - Country:US
Practice Address - Phone:917-804-5250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000000Medicaid