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General NPI Number Information
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NPI Number | 1396484812
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Entity Type | Organization
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Legal Business Name | NORTH FULTON COUNSELING PSYCHOTHERAPY AND CONSULTING
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 11285 EKINS ROAD SUITE SUITE D-2
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City | ROSWELL
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State | GA
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Zip | 30076-3007
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Country | US
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Telephone | 855-772-8884
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Fax | 404-365-3859
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Provider Business Mailing Address
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Address Line | 3211 CANYON POINT CIR
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City | ROSWELL
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State | GA
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Zip | 30076-5109
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Country | US
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Telephone | 678-469-1296
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Fax | 404-365-3859
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Authorized Official
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Title or Position | DIRECTOR/THERAPIST
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Name | JERRY WAYNE COX
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Credential | ED.S.
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Telephone | 678-469-1296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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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