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General NPI Number Information
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NPI Number | 1639567712
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Entity Type | Organization
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Legal Business Name | LIVE YOUR TRUTH COUNSELING AND CONSULTING SERVICES
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Dates
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Enumeration Date | 12/25/2014
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Last Update Date | 12/25/2014
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Provider Practice Location Address
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Address Line | 571 NECTAR LN
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City | ALBANY
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State | GA
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Zip | 31705-9505
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Country | US
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Telephone | 229-224-2407
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Fax | 229-889-0454
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Provider Business Mailing Address
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Address Line | 571 NECTAR LN
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City | ALBANY
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State | GA
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Zip | 31705-9505
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Country | US
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Telephone | 229-224-2407
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Fax | 229-889-0454
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Authorized Official
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Title or Position | THERAPIST
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Name | DR. SOPHIA JOHNSON
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Credential | EDD, LPC
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Telephone | 229-224-2407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | LPC007623
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LPC007623
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License Number State | GA
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