Healthcare Provider Details

I. General information

NPI: 1366965386
Provider Name (Legal Business Name): CIRCLE OF HANDS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 03/09/2025
Certification Date: 03/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 PARKER AVE S
BROOKLET GA
30415-8208
US

IV. Provider business mailing address

PO BOX 2
BROOKLET GA
30415-0002
US

V. Phone/Fax

Practice location:
  • Phone: 706-490-2555
  • Fax: 912-823-4232
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW003122
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. JERRI L FROST
Title or Position: OWNER
Credential: MSW, LCSW
Phone: 706-490-2555