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General NPI Number Information
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NPI Number | 1124329446
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Entity Type | Organization
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Legal Business Name | LIFE CLARITY GROUP
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 2336 WISTERIA DR SUITE 410
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City | SNELLVILLE
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State | GA
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Zip | 30078-6191
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Country | US
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Telephone | 404-857-7152
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Fax | 404-478-9525
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Provider Business Mailing Address
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Address Line | 3375 CENTERVILLE HWY #391711
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City | SNELLVILLE
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State | GA
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Zip | 30039-0133
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Country | US
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Telephone | 404-857-7152
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ALISHA MACAULEY
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Credential | LPC
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Telephone | 404-857-7152
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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 | 5320
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License Number State | GA
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