| Connect Four Counseling Llc | |
|
2020 Avalon Pkwy Suite 375 Mcdonough GA 30253-3087 | |
| (678) 833-1664 | |
| (678) 604-8585 |
| Full Name | Connect Four Counseling Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2020 Avalon Pkwy, Mcdonough, Georgia |
| Authorized Official Name and Position | Shawnette Nichole Miller (CLINICAL SOCIAL WORKER - THERAPIST) |
| Authorized Official Contact | 6788331664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connect Four Counseling Llc 2020 Avalon Pkwy Suite 375 Mcdonough GA 30253-3087 Ph: (678) 833-1664 | Connect Four Counseling Llc 2020 Avalon Pkwy Suite 375 Mcdonough GA 30253-3087 Ph: (678) 833-1664 |
| NPI Number | 1083086581 |
|---|---|
| Provider Enumeration Date | 10/22/2015 |
| Last Update Date | 10/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083086581 | NPI | - | NPPES |
| 003155030A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CSW004801 (Georgia) | Primary |
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