Healthcare Provider Details

I. General information

NPI: 1346696184
Provider Name (Legal Business Name): LIFE BEGINS HERE THERAPEUTIC & COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 17TH ST NW SUITE 300
ATLANTA GA
30363-1098
US

IV. Provider business mailing address

PO BOX 722
AUSTELL GA
30168-1051
US

V. Phone/Fax

Practice location:
  • Phone: 678-237-6540
  • Fax:
Mailing address:
  • Phone: 678-237-6540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLY M LEE-OKONYA
Title or Position: SOLE PROPRIETOR
Credential: LCSW
Phone: 678-237-6540