Provider Demographics
NPI:1043722705
Name:RADIANT COUNSELING, LLC
Entity type:Organization
Organization Name:RADIANT COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-595-4723
Mailing Address - Street 1:513 GLOUCESTER ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-7014
Mailing Address - Country:US
Mailing Address - Phone:912-580-9580
Mailing Address - Fax:912-289-9389
Practice Address - Street 1:513 GLOUCESTER ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-7014
Practice Address - Country:US
Practice Address - Phone:912-580-9580
Practice Address - Fax:912-289-9389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty