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General NPI Number Information
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NPI Number | 1033647110
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Entity Type | Organization
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Legal Business Name | OASIS OF SERENITY COUNSELING AND CONSULTING SERVICES, LLC
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 111 PETROL PT STE K
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1550
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Country | US
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Telephone | 470-377-6839
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Fax | 678-723-9016
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Provider Business Mailing Address
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Address Line | 111 PETROL PT STE K
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1550
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Country | US
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Telephone | 470-377-6839
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Fax | 678-723-9016
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Authorized Official
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Title or Position | CLINICIAN
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Name | MRS. SHARON GRANT
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Credential | LPC
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Telephone | 470-377-6839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | LPC006518
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License Number State | GA
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