Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Providence Residential & Outpatient PTSD Services, LLC

Organization Counselor · NPI 1215357272

Providence Residential & Outpatient PTSD Services, LLC is a Counselor in Douglasville, Georgia. Licensed in Georgia. Registered with an NPI since 2014.

Licensed in
GA
In the registry since
2014
Specialties on file
15
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6576 Church St
Douglasville, GA 30134-1884
Phone: (770) 577-7873
Fax: (770) 577-7871
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY003237 (GA)
Counselor Taxonomy 101Y00000X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
Professional Counselor Taxonomy 101YP2500X
Social Worker Taxonomy 104100000X
Clinical Social Worker Taxonomy 1041C0700X
Marriage & Family Therapist Taxonomy 106H00000X
Nutritionist Taxonomy 133N00000X
Registered Dietetic Technician Taxonomy 136A00000X
Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0808X
Licensed Practical Nurse Taxonomy 164W00000X
Acupuncturist Taxonomy 171100000X
Case Manager/Care Coordinator Taxonomy 171M00000X
Psychiatry Physician Taxonomy 2084P0800X
Technician Taxonomy 374700000X

Record details

NPI number1215357272
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Felicia Berry-Mitchell — President · (770) 577-7873
Other names Props
NPI enumeratedApril 17, 2014
Last updated in NPPESApril 17, 2014
Mailing address6576 Church St, Douglasville, GA 30134-1884

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