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General NPI Number Information
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NPI Number | 1598032146
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Entity Type | Organization
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Legal Business Name | A HEALING JOURNEY COUNSELING & CONSULTATION
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 109 CENTRAL AVE
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City | CARTERSVILLE
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State | GA
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Zip | 30120-3905
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Country | US
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Telephone | 770-983-4444
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Fax | 770-383-8930
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Provider Business Mailing Address
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Address Line | PO BOX 2603
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City | CARTERSVILLE
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State | GA
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Zip | 30120-1694
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Country | US
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Telephone | 770-983-4444
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Fax | 770-334-2739
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Authorized Official
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Title or Position | THERAPIST/CEO
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Name | MS. PAMELA A BRIDGEMAN
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Credential | LCSW
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Telephone | 770-983-4444
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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 | CSW004483
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License Number State | GA
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