Provider Demographics
NPI:1457543035
Name:VISION FOUNDATION COUNSELING CENTER, INC
Entity Type:Organization
Organization Name:VISION FOUNDATION COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:229-435-1729
Mailing Address - Street 1:1216 WHISPERING PINES RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3562
Mailing Address - Country:US
Mailing Address - Phone:229-435-1729
Mailing Address - Fax:229-435-1720
Practice Address - Street 1:1216 WHISPERING PINES RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3562
Practice Address - Country:US
Practice Address - Phone:229-435-1729
Practice Address - Fax:229-435-1720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA#214101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty