EXPANSION COUNSELING SERVICES LLC NPI 1720539562

NPI Information

NPI: 1720539562
Provider Name: EXPANSION COUNSELING SERVICES, LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
500 SUN VALLEY DRIVE D2
ROSWELL, GA
ZIP 30076
Phone: (770) 910-9162
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EXPANSION COUNSELING SERVICES, LLC is a professional counselor in Roswell, GA. EXPANSION COUNSELING SERVICES, LLC NPI is 1720539562. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

500 SUN VALLEY DRIVE D2
ROSWELL, GA
ZIP 30076
Phone: (770) 910-9162
Fax: (770) 910-9768

The provider's authorized official is Eboni R Mormant .
The authorized official title is Director and has the following contact phone number (770) 910-9162.

The enumeration date for this NPI number is 10/17/2016 and was last updated on 7/5/2023.

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			No
2	103TC0700X	Psychologist	Clinical			No
3	1041C0700X	Social Worker	Clinical			No
4	106H00000X	Marriage & Family Therapist				No
5	106S00000X	Behavior Technician				No
6	163WC1500X	Registered Nurse	Community Health			No
7	163WP0808X	Registered Nurse	Psychiatric/Mental Health			No
8	251S00000X	Community/Behavioral Health		1184963357	GEORGIA	No
9	251S00000X	Community/Behavioral Health				No
10	101YP2500X	Counselor	Professional			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	1720539562	OTHER	GEORGIA	GROUP NPI
2	003275832A	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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