Provider Demographics
NPI:1740498369
Name:LANIER COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:LANIER COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:P
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-271-9442
Mailing Address - Street 1:2070 BUFORD HWY
Mailing Address - Street 2:STE 2D
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-6079
Mailing Address - Country:US
Mailing Address - Phone:770-271-9442
Mailing Address - Fax:
Practice Address - Street 1:2070 BUFORD HWY
Practice Address - Street 2:STE 2D
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-6079
Practice Address - Country:US
Practice Address - Phone:770-271-9442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001864106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty