Medical Group Consultant LLC
Organization Active NPI Professional Counselor · Rex, GA
NPI 1346586567 · NPPES record last updated Dec 15, 2012
Key facts
- NPI
- 1346586567
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC5081 (GA)
- Legal business name
- MEDICAL GROUP CONSULTANT LLC
- Practice address
- 6337 Highway 42
Suite 3
Rex, GA 30273-1651 - Phone
- (404) 895-5510
- NPI assigned
- Dec 15, 2012
- Organization subpart
- No
Authorized official
- Name
- Holly Mims, LPC
- Title
- Clinical Director
- Phone
- (410) 905-5678
National Provider Directory
Locations
6337 Highway 42
Ste 3
Rex, GA 30273
Phone (404) 895-5510
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | LPC5081 | GA | |
| Mental Health Counselor |
101YM0800X | LPC5081 | GA | |
| Professional Counselor |
101YP2500X | LPC5081 | GA | Yes |
Addresses
Primary practice location
6337 Highway 42
Suite 3
Rex, GA 30273-1651
Mailing address
6337 Highway 42
Suite 3
Rex, GA 30273-1651
Phone (404) 895-5510
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003127731A | Medicaid | GA |
Other providers in Rex, GA
- LJB Non Medical Transportation
- Reginald Louis
- Denise Elecia Lyn-Bradley
- Janarra Kathryn Mallory-Crawford
- Maxine McGowan
- Karen N Miller
- Alisha Mitto
- Nakilaha Murray
- Beatrice Nduwimana
- Never Forgotten Transportation
All providers in Rex, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.