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General NPI Number Information
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NPI Number | 1326670043
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Entity Type | Organization
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Legal Business Name | STONE COTTAGE COUNSELING
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 2033 HOSEA L WILLIAMS DR SE STE 2
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City | ATLANTA
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State | GA
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Zip | 30317-2501
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Country | US
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Telephone | 404-490-1865
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Fax |
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Provider Business Mailing Address
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Address Line | 2033 HOSEA L WILLIAMS DR SE STE 2
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City | ATLANTA
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State | GA
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Zip | 30317-2501
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Country | US
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Telephone | 404-490-1865
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANA GOLDMAN
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Credential | LPC, NCC
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Telephone | 404-490-1865
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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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