Integrity Counseling and Personal Development LLC
Organization Active NPI Clinical Social Worker · Jefferson, GA
NPI 1457769739 · NPPES record last updated Jul 30, 2014
Key facts
- NPI
- 1457769739
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CSW004024 (GA)
- Legal business name
- INTEGRITY COUNSELING AND PERSONAL DEVELOPMENT LLC
- Practice address
- 83 Athens St
Jefferson, GA 30549-1401 - Phone
- (706) 387-0573
- Fax
- (706) 387-0573
- NPI assigned
- Jul 30, 2014
- Organization subpart
- No
Authorized official
- Name
- Christine B Dalton, LCSW
- Title
- Owner
- Phone
- (706) 387-0573
Practitioners 1
-
Christine B Dalton, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141015000752 | GA | Part B Supplier - Clinic/Group Practice | 7911128061 |
Receives reassigned benefits from 1 practitioner Practice locations: Jefferson, GA |
National Provider Directory
Locations
83 Athens St
Jefferson, GA 30549
Phone (706) 387-0573
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | CSW004024 | GA | Yes |
Addresses
Primary practice location
83 Athens St
Jefferson, GA 30549-1401
Mailing address
83 Athens St
Jefferson, GA 30549-1401
Phone (706) 387-0573
Other names
- Christine Dalton MBR
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- Jackson County B O C
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- Jackson County Health Department
- Jackson County Health Department
All providers in Jefferson, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.