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General NPI Number Information
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NPI Number | 1235004896
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Entity Type | Organization
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Legal Business Name | GUIDING LIGHT MENTAL HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 5887 GLENRIDGE DR STE 230
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City | ATLANTA
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State | GA
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Zip | 30328-9929
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Country | US
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Telephone | 770-740-7440
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Fax |
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Provider Business Mailing Address
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Address Line | 840 ERNEST W BARRETT PKWY NW UNIT 440452
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City | KENNESAW
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State | GA
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Zip | 30160-0103
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Country | US
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Telephone | 770-740-7440
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. DIAMOND BRIANNA JORDAN
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Credential | LPC
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Telephone | 770-740-7440
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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 |
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License Number State |
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