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General NPI Number Information
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NPI Number | 1447011424
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Entity Type | Organization
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Legal Business Name | TOTAL LIFE CARE COUNSELING
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 1790 CENTURY BLVD NE STE A
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City | ATLANTA
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State | GA
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Zip | 30345-3322
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Country | US
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Telephone | 404-671-9226
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Fax | 770-978-7676
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Provider Business Mailing Address
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Address Line | PO BOX 1218
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City | SNELLVILLE
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State | GA
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Zip | 30078-1218
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Country | US
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Telephone | 404-671-9226
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Fax | 770-978-7676
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Authorized Official
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Title or Position | PRESIDENT
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Name | RENE J ELY
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Credential | LMFT
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Telephone | 404-671-9226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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