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General NPI Number Information
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NPI Number | 1467342907
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Entity Type | Organization
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Legal Business Name | URBAN GATHERING COUNSELING LTD CO
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 11720 AMBER PARK DR STE 160
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City | ALPHARETTA
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State | GA
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Zip | 30009-2271
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Country | US
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Telephone | 334-552-1846
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Fax |
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Provider Business Mailing Address
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Address Line | 10620 COLONY GLEN DR
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City | ALPHARETTA
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State | GA
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Zip | 30022-4914
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Country | US
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Telephone | 334-552-1846
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Fax |
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Authorized Official
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Title or Position | PRINCIPLE CLINICIAN/OWNER
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Name | JOCLYN WINDOM
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Credential | LPC
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Telephone | 334-552-1846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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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