Healthcare Provider Details

I. General information

NPI: 1811269285
Provider Name (Legal Business Name): ARLEVIA PASCHAL DELOACH-WALLACE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3991 HIGHWAY 78 W STE 203
SNELLVILLE GA
30039-3929
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 770-978-9393
  • Fax:
Mailing address:
  • Phone: 770-978-9393
  • Fax: 706-432-3780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC006578
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: