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General NPI Number Information
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NPI Number | 1265911069
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Entity Type | Organization
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Legal Business Name | CHANGING LIVES COUNSELING SERVICES INC.
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 715 PEACHTREE ST NE
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City | ATLANTA
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State | GA
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Zip | 30308-1227
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Country | US
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Telephone | 404-772-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 10831 PANHANDLE RD
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City | HAMPTON
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State | GA
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Zip | 30228-1512
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Country | US
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Telephone | 404-772-4000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FELICIA MCDOWELL
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Credential |
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Telephone | 404-772-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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