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General NPI Number Information
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NPI Number | 1194340588
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Entity Type | Organization
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Legal Business Name | BETTER LIFE THERAPY LLC
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 175 LANGLEY DR STE A2
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-6952
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Country | US
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Telephone | 678-882-7924
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 888
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City | DACULA
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State | GA
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Zip | 30019-0015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/THERAPIST
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Name | JASMINE MCCOY
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Credential | LCSW
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Telephone | 678-925-7716
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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 |
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License Number State |
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