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NPI 1407522345

NPI 1407522345 : WELLNESS FIRST COUNSELING AND CONSULTING, LLC : HEPHZIBAH, GA

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General NPI Number Information
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    NPI Number           |    1407522345
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    Entity Type          |    Organization 
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    Legal Business Name  |    WELLNESS FIRST COUNSELING AND CONSULTING, LLC 
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Dates
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    Enumeration Date     |    08/20/2021
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    Last Update Date     |    08/20/2021
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Provider Practice Location Address
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    Address Line         |    3345 SADDLEBROOK DR 
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    City                 |    HEPHZIBAH
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    State                |    GA
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    Zip                  |    30815-6239
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    Country              |    US
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    Telephone            |    706-550-2206
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    Fax                  |    877-910-1304
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Provider Business Mailing Address
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    Address Line         |    2801 WASHINGTON RD STE107 BOX 261 
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    City                 |    AUGUSTA
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    State                |    GA
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    Zip                  |    30909
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    Country              |    US
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    Telephone            |    706-550-2206
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     COLISHA MARIE AMOS 
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    Credential           |    LPC
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    Telephone            |    706-550-2206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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