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General NPI Number Information
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NPI Number | 1760972038
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Entity Type | Organization
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Legal Business Name | AFFIRMATIVE TRANSFORMATION SERVICES, LLC
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Dates
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Enumeration Date | 05/13/2018
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Last Update Date | 05/13/2018
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Provider Practice Location Address
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Address Line | 507 AMBERLEY CT
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City | KATHLEEN
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State | GA
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Zip | 31047-2845
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Country | US
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Telephone | 478-227-6144
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Fax | 866-554-5153
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Provider Business Mailing Address
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Address Line | 507 AMBERLEY CT
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City | KATHLEEN
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State | GA
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Zip | 31047-2845
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Country | US
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Telephone | 478-225-3444
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISS YOLANDA KING
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Credential | LPC
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Telephone | 478-227-6144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LPC007036
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 1393590
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC007036
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License Number State | GA
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