FIRST RESPONSE COUNSELING & INTERVENTION LLC NPI 1093111049

NPI Information

NPI: 1093111049
Provider Name: FIRST RESPONSE COUNSELING & INTERVENTION LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
6053 N HENRY BLVD
SUITE C
STOCKBRIDGE, GA
ZIP 30281
Phone: (678) 545-4285
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FIRST RESPONSE COUNSELING & INTERVENTION LLC is a mental health counselor in Stockbridge, GA. FIRST RESPONSE COUNSELING & INTERVENTION LLC NPI is 1093111049. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6053 N HENRY BLVD
SUITE C
STOCKBRIDGE, GA
ZIP 30281-081
Phone: (678) 545-4285

The provider's authorized official is Damien Kellam .
The authorized official title is President & Ceo and has the following contact phone number (678) 545-4285.

The enumeration date for this NPI number is 11/18/2014 and was last updated on 11/18/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	LPC005856	GEORGIA	No
2	101YM0800X	Counselor	Mental Health	LPC005815	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003134017B	MEDICAID	GEORGIA
2	003134017A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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