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General NPI Number Information
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NPI Number | 1811624273
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Entity Type | Organization
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Legal Business Name | CALM WATERS COUNSELING LLC
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 4605 ORCHARD RIDGE CT
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City | CUMMING
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State | GA
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Zip | 30028-6977
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Country | US
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Telephone | 404-919-7334
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Fax |
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Provider Business Mailing Address
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Address Line | 4605 ORCHARD RIDGE CT
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City | CUMMING
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State | GA
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Zip | 30028-6977
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Country | US
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Telephone | 404-919-7334
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | LYNETTE CLARK
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Credential |
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Telephone | 770-339-7667
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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 |
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License Number State |
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