Healthcare Provider Details

I. General information

NPI: 1205752904
Provider Name (Legal Business Name): BRIGHTHOPE ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SENORA PL
MACON GA
31210-1582
US

IV. Provider business mailing address

121 SENORA PL
MACON GA
31210-1582
US

V. Phone/Fax

Practice location:
  • Phone: 478-370-8476
  • Fax: 888-798-7392
Mailing address:
  • Phone: 478-370-8476
  • Fax: 888-798-7392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARCUS PREVETTE
Title or Position: COUNSELOR / OWNER
Credential: LPC
Phone: 478-370-8476