MEDICARE: PRECIOUS MINDS COUNSELING & CONSULTING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	252Y00000X	Early Intervention Provider Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	261QM0850X	Adult Mental Health Clinic/Center
4	261QM0855X	Adolescent and Children Mental Health Clinic/Center
5	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336651272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECIOUS MINDS COUNSELING & CONSULTING, LLC

Provider Business Mailing Address
First Line	:	2462 HUGHES CT
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331
Country	:	US
Telephone Number	:	678-755-3443
Fax Number	:	404-883-2210

Provider Business Practice Location Address
First Line	:	2920 MACON RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31906-3034
Country	:	US
Telephone Number	:	706-507-3141
Fax Number	:	706-993-3295

Authorized Official
Title or Position	:	OWNER/PSYCHOTHERAPIST
Name	:	DR. LATOYA Y NELSON
Credential	:	ED.D
Telephone Number	:	678-755-3443

Provider Enumeration Date	:	11/01/2017
Last Update Date	:	03/17/2018

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Directions to “PRECIOUS MINDS COUNSELING & CONSULTING, LLC ” Practice Location

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