Providence Residential & Outpatient Ptsd Services, Llc
Counselor Clinic
6576 Church St, Douglasville
Georgia, 30134-1884
770-577-7873 770-577-7871
Maps & DirectionsProvidence Residential & Outpatient Ptsd Services, Llc is a Counselor Clinic in Douglasville, Georgia. It is located at 6576 Church St, Douglasville, GA and its contact number is 770-577-7873. The authorized person for Providence Residential & Outpatient Ptsd Services, Llc is Felicia Berry-mitchell
who is President of the clinic and his/her contact number is 770-577-7873. The primary license number for Providence Residential & Outpatient Ptsd Services, Llc is PSY003237 (Clinical) in Georgia.
Providence Residential & Outpatient Ptsd Services, Llc Clinic has counselors who are trained and educated in the performance of behavior health services through interpersonal communications and analysis. Counselors offer guidance to individuals, couples, families and groups who are dealing with issues that affect their mental health and well-being.
Complete Clinic Profile:
Providence Residential & Outpatient Ptsd Services, Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Providence Residential & Outpatient Ptsd Services, Llc |
| Specialization: | Counselor |
| Clinic Address: | 6576 Church St, Douglasville,
Georgia, 30134-1884 |
| Phone: | 770-577-7873 |
| Fax: | 770-577-7871 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Felicia Berry-mitchell |
| Position: | President |
| Contact Number: | 770-577-7873 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Providence Residential & Outpatient Ptsd Services, Llc clinic are as mentioned below.
| NPI Number: | 1215357272 |
| NPI Enumeration Date: | 17 Apr, 2014 |
| NPI Last Update On: | 17 Apr, 2014 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Providence Residential & Outpatient Ptsd Services, Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Clinical | PSY003237 | Georgia | Primary | |
| Counselor | | | Secondary | |
| Addiction (Substance Use Disorder) | | | Secondary | |
| Professional | | | Secondary | |
| Social Worker | | | Secondary | |
| Clinical | | | Secondary | |
| Marriage & Family Therapist | | | Secondary | |
| Nutritionist | | | Secondary | |
| Dietetic Technician, Registered | | | Secondary | |
| Psych/Mental Health | | | Secondary | |
| Licensed Practical Nurse | | | Secondary | |
| Acupuncturist | | | Secondary | |
| Case Manager/care Coordinator | | | Secondary | |
| Psychiatry | | | Secondary | |
| Technician | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 003132073B | Medicaid | Georgia | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Providence Residential & Outpatient Ptsd Services, Llc
6576 Church St,
Douglasville, Georgia |
| Zip: | 30134-1884 |
| Phone Number: | 770-577-7873 |
| Fax Number: | 770-577-7871 |
Patients can reach Providence Residential & Outpatient Ptsd Services, Llc at
6576 Church St, Douglasville, Georgia or can
call to book an appointment on 770-577-7873.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.