Organization

Tidwell& Miller Counseling Services, Llc

Clinical Social Worker in Decatur, GA(View on Map)

Legal Business Name

Tidwell& Miller Counseling Services, Llc

NPI Number

1902141617

NPI Type

Organization

Enumeration Date

12/06/2012

Specialties

(Taxonomies)

Code

1041C0700X

Primary Taxonomy

Yes

Licenses

State

Georgia

License Number

CSW000649

Contact
Information

Purpose

Mailing
Location

Address

215 CHURCH ST STE 105
215 CHURCH ST STE 105

City

Decatur
Decatur

State

GA
GA

Postal Code

30030-3330
30030-3330

Country

US
US

Telephone Number

(404) 626-9690
(404) 626-9690

Authorized Official

Name

Ms. Phyllis Miller

Title or Position

MANAGING PARTNER

Telephone Number

(404) 626-9690

Identifiers

Identifier

1053692848
1750602173
003112377A

Identifier State

GA
GA
GA

Identifier Issuer

INDIVIDUAL NPI
ORGANIZATIONAL NPI
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/06/2012

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