Healthcare Provider Details

I. General information

NPI: 1427717867
Provider Name (Legal Business Name): VISIONS COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4426 HUGH HOWELL RD STE B207
TUCKER GA
30084-4918
US

IV. Provider business mailing address

4426 HUGH HOWELL RD STE B-207
TUCKER GA
30084-4918
US

V. Phone/Fax

Practice location:
  • Phone: 678-793-9151
  • Fax:
Mailing address:
  • Phone: 678-793-9151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA BEA POLLARD
Title or Position: CLINICAL DIRECTOR
Credential: LPC
Phone: 678-793-9151