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General NPI Number Information
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NPI Number | 1154832772
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Entity Type | Organization
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Legal Business Name | CLARITY COUNSELING ATLANTA LLC
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 2751 BUFORD HWY NE STE 700
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City | ATLANTA
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State | GA
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Zip | 30324-5510
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Country | US
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Telephone | 770-912-0234
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Fax |
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Provider Business Mailing Address
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Address Line | 2413 SHERBROOKE DR NE
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City | ATLANTA
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State | GA
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Zip | 30345-1936
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Country | US
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Telephone | 770-912-0234
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER SHAW
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Credential | LCSW
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Telephone | 770-912-0234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW005865
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License Number State | GA
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