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General NPI Number Information
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NPI Number | 1457981763
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Entity Type | Organization
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Legal Business Name | ASIKARI PERFECT IMPACT, LLC.
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Dates
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Enumeration Date | 01/26/2020
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Last Update Date | 01/26/2020
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Provider Practice Location Address
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Address Line | 235 PEACHTREE ST NE STE 400
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City | ATLANTA
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State | GA
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Zip | 30303-1400
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Country | US
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Telephone | 678-270-6712
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Fax |
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Provider Business Mailing Address
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Address Line | 5472 SHIREWICK LN
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City | LITHONIA
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State | GA
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Zip | 30058-3872
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Country | US
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Telephone | 678-270-6712
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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 | MISS JOHANNA ELIZABETH HARRIS
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Credential | LPC
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Telephone | 678-270-6712
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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 |
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License Number State |
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