Healthcare Provider Details

I. General information

NPI: 1235685082
Provider Name (Legal Business Name): EIRAM COUNSELING & CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6605 ABERCORN STREET SUITE 108
SAVANNAH GA
31406
US

IV. Provider business mailing address

5710 OGEECHEE RD STE 200 RM 271
SAVANNAH GA
31405-9559
US

V. Phone/Fax

Practice location:
  • Phone: 912-275-4967
  • Fax: 912-228-3440
Mailing address:
  • Phone: 912-275-4967
  • Fax: 912-228-3440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number508334
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC004748
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number465919
License Number StateGA

VIII. Authorized Official

Name: TIHESHA M LEMON-DEACON
Title or Position: CEO/OWNER
Credential: LPC
Phone: 912-484-7599