Counseling Services of Lagrange, Inc.

NPI #1790197804 in Lagrange, Georgia

Provider Information

NPI Number: 1790197804
Entity Type: Organization
Organization Name: Counseling Services of Lagrange, Inc.
Primary Specialty: Psychologist - Clinical
Enumeration Date: May 22, 2014
Last Updated: Jun 29, 2015

Practice Location

Address: 610 RIDLEY AVE
City: Lagrange
State: Georgia
ZIP Code: 30240-2236
Phone: (706) 884-5050

Authorized Official

Name: SHANNON KEITH DUNLAP, PHD
Title: OWNER/DIRECTOR
Phone: (706) 884-5050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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