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General NPI Number Information
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NPI Number | 1235973488
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Entity Type | Organization
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Legal Business Name | PLAYHEALS-A THERAPEUTIC COUNSELING FACILITY
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Dates
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Enumeration Date | 06/22/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 1885 WESTON LN
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City | TUCKER
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State | GA
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Zip | 30084-5503
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Country | US
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Telephone | 678-431-0064
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Fax |
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Provider Business Mailing Address
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Address Line | 1885 WESTON LN
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City | TUCKER
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State | GA
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Zip | 30084-5503
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Country | US
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Telephone | 678-431-0064
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. CHASSITY TODD
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Credential | PHD, LPC, NCC, ACS
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Telephone | 678-431-0064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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