| Rivendell Counselors, Llc | |
|
3617 Braselton Hwy Ste 104 Dacula GA 30019-4667 | |
| (678) 687-1495 | |
| Not Available |
| Full Name | Rivendell Counselors, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3617 Braselton Hwy Ste 104, Dacula, Georgia |
| Authorized Official Name and Position | Tanya Thomas (OWNER) |
| Authorized Official Contact | 6786871495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivendell Counselors, Llc 3617 Braselton Hwy Ste 104 Dacula GA 30019-4667 Ph: (678) 687-1495 | Rivendell Counselors, Llc 3617 Braselton Hwy Ste 104 Dacula GA 30019-4667 Ph: (678) 687-1495 |
| NPI Number | 1871308221 |
|---|---|
| Provider Enumeration Date | 02/12/2025 |
| Last Update Date | 02/12/2025 |
| Certification Date | 02/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871308221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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