=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275044802
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ENAYA COUNSELING AND CONSULTING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/23/2017
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 555 SUN VALLEY DR STE G4
-----------------------------------------------------
City | ROSWELL
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30076-5607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-235-5054
-----------------------------------------------------
Fax | 678-810-0666
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4470 MOSSBROOK CIR
-----------------------------------------------------
City | ALPHARETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30004-4475
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-313-2772
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COUNSELING PSYCHOLOGIST
-----------------------------------------------------
Name | DR. FATIMA WASIM
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 678-313-2772
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number | PSY004097
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------