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General NPI Number Information
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NPI Number | 1174480040
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Entity Type | Organization
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Legal Business Name | ALD SUCCESS NETWORK, INC. DBA: EMPOWERED HARMONY COUNSELING, PSYCHIATRY & WELLNESS CENTER
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 2739 LOST LAKES DR
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-6012
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Country | US
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Telephone | 877-427-6879
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Fax | 877-497-6576
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Provider Business Mailing Address
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Address Line | 1914 THOMES AVE., SUITE 2 #5710
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City | CHEYENNE
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State | WY
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Zip | 82001-3527
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Country | US
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Telephone | 877-427-6879
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Fax | 877-497-6576
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Authorized Official
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Title or Position | CCWO
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Name | YASHICA MAXWELL
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Credential | LCSW, LICSW
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Telephone | 616-920-0483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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