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General NPI Number Information
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NPI Number | 1295492684
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Entity Type | Organization
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Legal Business Name | MINDFUL JOURNEYS COUNSELING LLC
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Dates
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Enumeration Date | 11/20/2021
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 3949 HOLCOMB BRIDGE RD STE 200
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30092-2208
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Country | US
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Telephone | 404-369-3985
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Fax |
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Provider Business Mailing Address
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Address Line | 3445 HIGHCROFT CIR
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30092-4964
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Country | US
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Telephone | 678-923-4680
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | JACOB MICHAEL SOBEL
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Credential | LCSW
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Telephone | 404-369-3985
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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