Provider Demographics
NPI:1457541823
Name:LANDMARK COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:LANDMARK COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER/LPC
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:Q
Authorized Official - Last Name:ROPER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPC, NCC
Authorized Official - Phone:706-576-6575
Mailing Address - Street 1:2013 DEVONSHIRE DRIVE, SUITE 115
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904
Mailing Address - Country:US
Mailing Address - Phone:706-576-6575
Mailing Address - Fax:706-507-0590
Practice Address - Street 1:2013 DEVONSHIRE DR, SUITE 115
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-576-6575
Practice Address - Fax:706-507-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA238939305S00000X
305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service