Healthcare Provider Details

I. General information

NPI: 1710808027
Provider Name (Legal Business Name): CANOPY COUNSELING & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2346 WILDERNESS WAY FL 1
MARIETTA GA
30066-5754
US

IV. Provider business mailing address

3343 PEACHTREE RD NE STE 145
ATLANTA GA
30326-1427
US

V. Phone/Fax

Practice location:
  • Phone: 470-285-9746
  • Fax: 470-893-8978
Mailing address:
  • Phone: 470-285-9746
  • Fax: 470-893-8978

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: DELARUELLE BRUMSKINE
Title or Position: LEAD CLINICAN & FOUNDER
Credential: LCSW
Phone: 470-285-9746