Healthcare Provider Details

I. General information

NPI: 1386330546
Provider Name (Legal Business Name): GIRASOLES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 05/13/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 HENDERSON DR STE 406
CARTERSVILLE GA
30120-3758
US

IV. Provider business mailing address

PO BOX 2373
CARTERSVILLE GA
30120-1690
US

V. Phone/Fax

Practice location:
  • Phone: 770-334-2493
  • Fax: 770-334-2675
Mailing address:
  • Phone: 404-590-6947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA CRISTINA MONCAYO GILSTRAP
Title or Position: BUSINESS OWNER/ LPC
Credential: LPC, CCTP, CADC-II
Phone: 404-590-6947