| Brantley Counseling Llc | |
|
518 Couper Rd Waynesville GA 31566-3438 | |
| (912) 292-6087 | |
| (912) 244-9914 |
| Full Name | Brantley Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 518 Couper Rd, Waynesville, Georgia |
| Authorized Official Name and Position | Crystal J Wright (SOLE MEMBER) |
| Authorized Official Contact | 9122926087 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brantley Counseling Llc Po Box 254 Waynesville GA 31566-0254 Ph: (912) 292-6087 | Brantley Counseling Llc 518 Couper Rd Waynesville GA 31566-3438 Ph: (912) 292-6087 |
| NPI Number | 1497201719 |
|---|---|
| Provider Enumeration Date | 08/28/2016 |
| Last Update Date | 01/24/2024 |
| Certification Date | 01/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497201719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW 34536 (Idaho) | Primary |