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General NPI Number Information
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NPI Number | 1134577489
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Entity Type | Organization
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Legal Business Name | HEART FELT COUNSELING CENTER
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 10884 SOUTHSHORE CT
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City | HAMPTON
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State | GA
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Zip | 30228-6175
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Country | US
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Telephone | 678-522-5687
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Fax |
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Provider Business Mailing Address
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Address Line | 10884 SOUTHSHORE CT
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City | HAMPTON
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State | GA
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Zip | 30228-6175
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Country | US
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Telephone | 678-522-5687
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Fax |
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Authorized Official
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Title or Position | MAC/OWNER
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Name | DR. LUKETHIA DENISE OGOE
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Credential | PHD
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Telephone | 770-472-9110
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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 | 572508122010
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License Number State | AL
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