NPI 1184095937

Ebenezer Counseling and Consulting LLC

Organisation Health Maintenance Organization Atlanta, GA

Practice location

Address: 5825 Glenridge Dr. Bdl. 3 Suite 101, Atlanta, GA 30328
Phone: (404) 556-9544
Mailing address: 656 Simon Ive Drive, Lawrenceville, GA 30045

Authorised official

Name: Trevor T Knight
Title: Therapist
Phone: (404) 556-9544

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence LPC008502 (GA)

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Registry record

NPI: 1184095937
Entity type: Organization
NPI issued: 19 Oct 2015
Record last updated: 19 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.