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General NPI Number Information
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NPI Number | 1669341210
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Entity Type | Organization
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Legal Business Name | SACRED SOUL WELLNESS & COUNSELING
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 401 WESTPARK CT STE 200
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-3572
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Country | US
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Telephone | 678-783-0110
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Fax |
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Provider Business Mailing Address
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Address Line | 305 PARK CHASE CT
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City | GRIFFIN
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State | GA
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Zip | 30224-5456
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | PRECIOUS T PARHAM
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Credential | LCSW
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Telephone | 404-436-6642
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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 |
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License Number State |
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