Healthcare Provider Details

I. General information

NPI: 1275044802
Provider Name (Legal Business Name): ENAYA COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 09/11/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 SUN VALLEY DR STE G4
ROSWELL GA
30076-5607
US

IV. Provider business mailing address

4470 MOSSBROOK CIR
ALPHARETTA GA
30004-4475
US

V. Phone/Fax

Practice location:
  • Phone: 678-235-5054
  • Fax: 678-810-0666
Mailing address:
  • Phone: 678-313-2772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberPSY004097
License Number StateGA

VIII. Authorized Official

Name: DR. FATIMA WASIM
Title or Position: COUNSELING PSYCHOLOGIST
Credential: PHD
Phone: 678-313-2772