Healthcare Provider Details

I. General information

NPI: 1851115901
Provider Name (Legal Business Name): ABUNDANT ZEAL COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 LANIER AVE W STE 200
FAYETTEVILLE GA
30214-7443
US

IV. Provider business mailing address

320 LANIER AVE W STE 200
FAYETTEVILLE GA
30214-7443
US

V. Phone/Fax

Practice location:
  • Phone: 404-450-2213
  • Fax:
Mailing address:
  • Phone: 404-450-2213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ARNETTE ZIMMERMAN
Title or Position: OWNER/CEO
Credential: LPC
Phone: 404-450-2213