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General NPI Number Information
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NPI Number | 1770081036
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Entity Type | Organization
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Legal Business Name | RENEWED YOU COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 2993 SANDY PLAINS RD STE 125
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City | MARIETTA
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State | GA
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Zip | 30066-4695
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Country | US
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Telephone | 404-849-2543
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Fax |
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Provider Business Mailing Address
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Address Line | 2266 SEATTON CT
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City | MARIETTA
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State | GA
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Zip | 30062-8606
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Country | US
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Telephone | 404-849-2543
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Fax |
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | SHARON BURTZLAFF
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Credential | MA, LPC
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Telephone | 404-849-2543
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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 | LPC009801
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License Number State | GA
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