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General NPI Number Information
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NPI Number | 1396320180
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Entity Type | Organization
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Legal Business Name | FLOURISH COUNSELING AND WELLNESS
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Dates
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Enumeration Date | 03/12/2021
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | 2483 HERITAGE VLG STE 16-139
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City | SNELLVILLE
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State | GA
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Zip | 30078-6140
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Country | US
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Telephone | 470-709-2792
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Fax |
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Provider Business Mailing Address
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Address Line | 2483 HERITAGE VLG STE 16-139
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City | SNELLVILLE
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State | GA
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Zip | 30078-6140
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Country | US
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Telephone | 470-709-2792
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. BERNESHA PARKS
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Credential | ED.S, LPC
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Telephone | 404-694-5626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 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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