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General NPI Number Information
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NPI Number | 1154097178
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Entity Type | Organization
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Legal Business Name | CREATING NEW BEGINNINGS COUNSELING & CONSULTING LLC
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 3350 NORTHLAKE PKWY NE
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City | ATLANTA
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State | GA
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Zip | 30345-2204
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Country | US
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Telephone | 404-202-2061
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Fax |
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Provider Business Mailing Address
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Address Line | 1135 HUNTINGTON PLACE CIR
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City | LITHONIA
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State | GA
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Zip | 30058-3036
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Country | US
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Telephone | 404-202-2061
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CANDICE NORRIS-BROWN
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Credential | PHD
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Telephone | 404-202-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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