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General NPI Number Information
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NPI Number | 1417478439
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Entity Type | Organization
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Legal Business Name | REEXIST COUNSELING LLC
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1955 VANCE DRIVE NE
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City | ATLANTA
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State | GA
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Zip | 30345
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Country | US
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Telephone | 901-826-1560
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Fax |
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Provider Business Mailing Address
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Address Line | 1955 VANCE DR NE
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City | ATLANTA
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State | GA
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Zip | 30345-3015
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Country | US
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Telephone | 901-826-1560
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ERIN ROGERS
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Credential | LPC
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Telephone | 901-826-1560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 1309
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | LPC009334
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License Number State | GA
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