| Destined To Reign Counseling Services, L.l.c. | |
|
2224 Lake Harbin Rd Morrow GA 30260-1907 | |
| (404) 441-7918 | |
| Not Available |
| Full Name | Destined To Reign Counseling Services, L.l.c. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2224 Lake Harbin Rd, Morrow, Georgia |
| Authorized Official Name and Position | Damien Kellam (PRESIDENT/LICENSED PSYCHOTHERAPIST) |
| Authorized Official Contact | 7708756760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Destined To Reign Counseling Services, L.l.c. 2224 Lake Harbin Rd Morrow GA 30260-1907 Ph: (404) 441-7918 | Destined To Reign Counseling Services, L.l.c. 2224 Lake Harbin Rd Morrow GA 30260-1907 Ph: (404) 441-7918 |
| NPI Number | 1689001117 |
|---|---|
| Provider Enumeration Date | 09/30/2013 |
| Last Update Date | 09/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689001117 | NPI | - | NPPES |
| 003134017A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC005815 (Georgia) | Primary |
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