Healthcare Provider Details

I. General information

NPI: 1669024733
Provider Name (Legal Business Name): TLC COUNSELING & CONSULTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5835 CAMPBELLTON RD SW STE 303
ATLANTA GA
30331-8014
US

IV. Provider business mailing address

5835 CAMPBELLTON RD SW STE 303
ATLANTA GA
30331-8014
US

V. Phone/Fax

Practice location:
  • Phone: 404-422-9992
  • Fax: 404-559-8755
Mailing address:
  • Phone: 404-422-9992
  • Fax: 404-559-8755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TASHIKA HOLLOWAY
Title or Position: OWNER
Credential:
Phone: 404-422-9992