Healthcare Provider Details

I. General information

NPI: 1053240499
Provider Name (Legal Business Name): EDITIONS OF YOU PSYCHOTHERAPY & ART THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3546 HABERSHAM AT NORTHLAKE STE 200
TUCKER GA
30084-4009
US

IV. Provider business mailing address

3546 HABERSHAM AT NORTHLAKE STE 200
TUCKER GA
30084-4009
US

V. Phone/Fax

Practice location:
  • Phone: 347-633-0494
  • Fax:
Mailing address:
  • Phone: 347-633-0494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KELLEY COLLINS
Title or Position: OWNER
Credential: LPC, ATR
Phone: 347-633-0494