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General NPI Number Information
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NPI Number | 1538369442
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Entity Type | Organization
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Legal Business Name | ATLAS COUNSELING PLLC
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 06/24/2010
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Provider Practice Location Address
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Address Line | 816 BRAWLEY SCHOOL RD STE F 4
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City | MOORESVILLE
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State | NC
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Zip | 28117-6201
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Country | US
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Telephone | 704-658-9676
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Fax | 704-799-3258
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Provider Business Mailing Address
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Address Line | 816 BRAWLEY SCHOOL RD STE F 4
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City | MOORESVILLE
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State | NC
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Zip | 28117-6201
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Country | US
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Telephone | 704-658-9676
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Fax | 704-799-3258
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Authorized Official
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Title or Position | MANAGER PSYCHOTHERAPIST
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Name | MS. MARILYN S ATLAS
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Credential | LCSW
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Telephone | 704-658-9676
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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 | C004741
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License Number State | NC
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