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General NPI Number Information
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NPI Number | 1124912662
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Entity Type | Organization
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Legal Business Name | GRACEFUL SERENITY COUNSELING LLC
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1775 PARKER RD SE STE 210
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City | CONYERS
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State | GA
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Zip | 30094-6654
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Country | US
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Telephone | 678-807-9594
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Fax | 470-974-2175
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Provider Business Mailing Address
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Address Line | 898 SWEET BRIAR TRL SE
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City | CONYERS
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State | GA
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Zip | 30094-3854
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Country | US
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Telephone | 347-346-0156
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | OLIVIA GORDON-THOMAS
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Credential | LPC. NCC
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Telephone | 678-807-9594
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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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