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General NPI Number Information
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NPI Number | 1003562083
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Entity Type | Organization
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Legal Business Name | NOW: NEW OPPORTUNITIES WAITING
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 3774 LAVISTA RD STE 100B
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City | TUCKER
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State | GA
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Zip | 30084-5618
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Country | US
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Telephone | 404-909-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 2890 GEORGIA HIGHWAY 212 SW STE A-319
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City | CONYERS
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State | GA
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Zip | 30094-3363
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Country | US
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Telephone | 404-909-4100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAMILLE A COLSON
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Credential | LPC, CPCS, CRC
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Telephone | 404-909-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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