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General NPI Number Information
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NPI Number | 1619719028
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Entity Type | Organization
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Legal Business Name | PEACEFUL JOURNEY COUNSELING LLC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 6825 DEER LAKE CT
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-5407
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Country | US
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Telephone | 678-777-2253
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Fax |
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Provider Business Mailing Address
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Address Line | 6825 DEER LAKE CT
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-5407
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Country | US
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Telephone | 678-777-2253
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Fax |
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Authorized Official
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Title or Position | OWNER / COUNSELOR
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Name | MS. ANDREA MELIA CRAWLEY
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Credential | LPC
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Telephone | 678-777-2253
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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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