Healthcare Provider Details

I. General information

NPI: 1962891853
Provider Name (Legal Business Name): PRACTICAL SOLUTIONS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2015
Last Update Date: 04/27/2024
Certification Date: 04/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 MANSELL RD STE A107
ROSWELL GA
30076-5019
US

IV. Provider business mailing address

1007 MANSELL RD STE A107
ROSWELL GA
30076-5019
US

V. Phone/Fax

Practice location:
  • Phone: 678-667-1673
  • Fax:
Mailing address:
  • Phone: 678-667-1673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCSW004647
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JEANIE WITCRAFT SHIAU
Title or Position: CEO/OWNER
Credential: LCSW
Phone: 678-667-1673