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General NPI Number Information
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NPI Number | 1417847757
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Entity Type | Organization
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Legal Business Name | THE DISTINGUISHED LOC'D DOULA LLC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 2451 CUMBERLAND PKWY SE STE 3152
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City | ATLANTA
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State | GA
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Zip | 30339-6136
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Country | US
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Telephone | 678-667-3885
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Fax | 833-411-1598
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Provider Business Mailing Address
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Address Line | 2451 CUMBERLAND PKWY SE STE 3152
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City | ATLANTA
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State | GA
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Zip | 30339-6136
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Country | US
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Telephone | 678-667-3885
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Fax | 833-411-1598
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Authorized Official
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Title or Position | CEO
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Name | CHASTIDY HARVEY
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Credential | LMSW
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Telephone | 678-667-3885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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