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General NPI Number Information
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NPI Number | 1457865941
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 445 WINDY HILL RD SE STE 425
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City | MARIETTA
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State | GA
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Zip | 30060-7348
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Country | US
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Telephone | 770-896-2124
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Fax | 678-217-4154
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Provider Business Mailing Address
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Address Line | 1975 BRAYTON CT
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City | MARIETTA
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State | GA
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Zip | 30060-9015
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Country | US
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Telephone | 770-896-2124
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Fax |
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Authorized Official
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Title or Position | LICENCE PROFESSIONAL COUNSELOR
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Name | REBECCA BROWN
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Credential | LPC
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Telephone | 770-896-2124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC009692
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License Number State | GA
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