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General NPI Number Information
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NPI Number | 1316828601
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Entity Type | Organization
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Legal Business Name | GREATWORKS COUNSELING, LLC
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 217 BRISTLELEAF PATH
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City | KATHLEEN
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State | GA
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Zip | 31047-2986
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Country | US
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Telephone | 478-213-9140
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Fax |
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Provider Business Mailing Address
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Address Line | 217 BRISTLELEAF PATH
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City | KATHLEEN
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State | GA
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Zip | 31047-2986
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Country | US
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Telephone | 478-213-9140
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. PAMELA JEAN DAVIS
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Credential | LPC
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Telephone | 478-210-8318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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