Healthcare Provider Details

I. General information

NPI: 1043125552
Provider Name (Legal Business Name): FIG & OLIVE THERAPY CO., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 SEALS ROAD
DALLAS GA
30157-8668
US

IV. Provider business mailing address

7951 VILLA RICA HWY STE 135
DALLAS GA
30157-8668
US

V. Phone/Fax

Practice location:
  • Phone: 678-439-9293
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: TIFINI SMITH
Title or Position: CLINICIAN
Credential:
Phone: 678-439-9293