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General NPI Number Information
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NPI Number | 1679065783
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Entity Type | Organization
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Legal Business Name | BRIGHT PATH COUNSELING AND CONSULTING LLC
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Dates
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Enumeration Date | 06/04/2018
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 5415 SUGARLOAF PKWY STE 2208
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7832
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Country | US
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Telephone | 770-676-0737
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Fax | 678-828-5540
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Provider Business Mailing Address
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Address Line | 5415 SUGARLOAF PKWY STE 2208
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7832
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Country | US
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Telephone | 770-676-0737
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Fax | 678-828-5540
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Authorized Official
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Title or Position | OWNER
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Name | BRANDY ROGERS
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Credential | MS, LPC
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Telephone | 770-676-0737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC006397
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License Number State | GA
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