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General NPI Number Information
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NPI Number | 1104235696
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Entity Type | Organization
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Legal Business Name | HIGHER GROUND COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 11675 CENTURY DR SUITE C
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City | ALPHARETTA
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State | GA
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Zip | 30009-8366
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Country | US
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Telephone | 770-864-2125
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Fax | 678-551-7229
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Provider Business Mailing Address
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Address Line | 11675 CENTURY DR SUITE C
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City | ALPHARETTA
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State | GA
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Zip | 30009-8366
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Country | US
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Telephone | 770-864-2125
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Fax | 678-551-7229
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Authorized Official
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Title or Position | OWNER/LPC
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Name | STEPHANIE G MONTWID
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Credential | LPC
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Telephone | 770-864-2125
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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 | LPC007468
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License Number State | GA
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