Healthcare Provider Details

I. General information

NPI: 1336651272
Provider Name (Legal Business Name): PRECIOUS MINDS COUNSELING & CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 MACON RD
COLUMBUS GA
31906-3034
US

IV. Provider business mailing address

2462 HUGHES CT
ATLANTA GA
30331
US

V. Phone/Fax

Practice location:
  • Phone: 706-507-3141
  • Fax: 706-993-3295
Mailing address:
  • Phone: 678-755-3443
  • Fax: 404-883-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LATOYA Y NELSON
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: ED.D
Phone: 678-755-3443