Healthcare Provider Details

I. General information

NPI: 1356029268
Provider Name (Legal Business Name): POISED PERSEVERANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1827 POWERS FERRY RD SE BLDG 22
ATLANTA GA
30339-5621
US

IV. Provider business mailing address

170 MIRRAMONT LAKE DR
WOODSTOCK GA
30189-8183
US

V. Phone/Fax

Practice location:
  • Phone: 770-953-4640
  • Fax:
Mailing address:
  • Phone: 770-953-4640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN GELFAND
Title or Position: OWNER
Credential: LPC
Phone: 718-662-8034