Healthcare Provider Details

I. General information

NPI: 1194654756
Provider Name (Legal Business Name): PER BADILIKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PARSONS RDG
JOHNS CREEK GA
30097-7715
US

IV. Provider business mailing address

1900 PARSONS RDG
JOHNS CREEK GA
30097-7715
US

V. Phone/Fax

Practice location:
  • Phone: 404-532-9579
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAKEESHA GOSS
Title or Position: OWNER
Credential:
Phone: 404-532-9579