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NPI Code Detail

MEDICARE: OPTIMUM PURPOSE COUNSELING AND EDUCATION

MEDICARE: OPTIMUM PURPOSE COUNSELING AND EDUCATION
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1427579721
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTIMUM PURPOSE COUNSELING AND EDUCATION
Provider Business Mailing Address
First Line : 2255 SATELLITE BLVD APT J302
Second Line :
City : DULUTH
State : GA
Zip : 30097-6264
Country : US
Telephone Number : 610-509-5055
Fax Number :
Provider Business Practice Location Address
First Line : 2180 SATELLITE BLVD STE 400
Second Line :
City : DULUTH
State : GA
Zip : 30097-4927
Country : US
Telephone Number : 678-744-7243
Fax Number :
Authorized Official
Title or Position : CEO
Name : NICKIA LOWERY
Credential : MHS, LPC, NCC
Telephone Number : 610-509-5055
Provider Enumeration Date : 06/28/2017
Last Update Date : 03/17/2018

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Directions to “OPTIMUM PURPOSE COUNSELING AND EDUCATION ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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