| Connecting Generations Inc. | |
|
2227 Godby Rd Ste 110 College Park GA 30349-5018 | |
| (678) 732-9531 | |
| (678) 732-9245 |
| Full Name | Connecting Generations Inc. |
|---|---|
| Speciality | Counselor |
| Location | 2227 Godby Rd Ste 110, College Park, Georgia |
| Authorized Official Name and Position | Latasha L. Blissett (PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7703316576 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Connecting Generations Inc. Po Box 962783 Riverdale GA 30296-6928 Ph: (770) 331-6576 | Connecting Generations Inc. 2227 Godby Rd Ste 110 College Park GA 30349-5018 Ph: (678) 732-9531 |
| NPI Number | 1437392461 |
|---|---|
| Provider Enumeration Date | 04/06/2009 |
| Last Update Date | 10/29/2024 |
| Certification Date | 10/29/2024 |
| Medicare PECOS PAC ID | 8426587403 |
|---|---|
| Medicare Enrollment ID | O20250121000245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437392461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Latasha Latrice Blissett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730429978 PECOS PAC ID: 2062941040 Enrollment ID: I20250213001030 |
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