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General NPI Number Information
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NPI Number | 1285275867
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Entity Type | Organization
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Legal Business Name | JOURNEY 2 GREATNESS
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Dates
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Enumeration Date | 10/04/2019
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 2751 BUFORD HWY NE
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City | ATLANTA
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State | GA
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Zip | 30324-3207
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Country | US
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Telephone | 678-744-5965
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Fax |
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Provider Business Mailing Address
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Address Line | 8275 EASTSHORE DR
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City | UNION CITY
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State | GA
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Zip | 30291-6028
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Country | US
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Telephone | 678-744-6965
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Fax |
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Authorized Official
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Title or Position | OWNER, LPC
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Name | MRS. SHENITHIA SHONTEL ARNOLD
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Credential | EDD, LPC, NCC
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Telephone | 678-744-6965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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