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General NPI Number Information
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NPI Number | 1023478187
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Entity Type | Organization
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Legal Business Name | BALANCED PATH COUNSELING
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 8046 ROSWELL RD STE 101C
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City | SANDY SPRINGS
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State | GA
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Zip | 30350-7023
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Country | US
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Telephone | 770-833-6052
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Fax | 877-262-0792
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Provider Business Mailing Address
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Address Line | 1220 WITHAM DR
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City | DUNWOODY
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State | GA
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Zip | 30338-3335
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Country | US
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Telephone | 770-833-6052
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HERBERT COLE
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Credential | LPC
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Telephone | 770-833-6052
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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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