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General NPI Number Information
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NPI Number | 1356989404
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Entity Type | Organization
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Legal Business Name | THRIVE COUNSELING ATLANTA
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Dates
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Enumeration Date | 12/18/2019
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Last Update Date | 05/04/2025
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Provider Practice Location Address
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Address Line | 3754 LAVISTA RD STE 200
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City | TUCKER
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State | GA
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Zip | 30084-5627
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Country | US
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Telephone | 770-827-7420
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Fax |
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Provider Business Mailing Address
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Address Line | 3754 LAVISTA RD STE 200
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City | TUCKER
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State | GA
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Zip | 30084-5627
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Country | US
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Telephone | 770-827-7420
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES DEVON MILLS
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Credential | LPC
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Telephone | 770-827-7420
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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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