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General NPI Number Information
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NPI Number | 1003635731
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Entity Type | Organization
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Legal Business Name | TOLLESON COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 1640 POWERS FERRY RD SE BLDG 9-350
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City | MARIETTA
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State | GA
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Zip | 30067-5484
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Country | US
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Telephone | 470-684-0428
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Fax |
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Provider Business Mailing Address
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Address Line | 1640 POWERS FERRY RD SE BLDG 9-350
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City | MARIETTA
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State | GA
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Zip | 30067-5484
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Country | US
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Telephone | 470-684-0428
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICAL SUPERVISOR
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Name | DR. ASHLEY MICHELE TOLLESON
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Credential | PH.D., LPC, NCC
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Telephone | 470-684-0428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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