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General NPI Number Information
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NPI Number | 1851784516
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Entity Type | Organization
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Legal Business Name | ELISE BERRYHILL COUNSELING
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Dates
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Enumeration Date | 03/05/2015
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Last Update Date | 03/05/2015
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Provider Practice Location Address
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Address Line | 750 HAMMOND DR BLDG 4
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City | ATLANTA
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State | GA
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Zip | 30328-5532
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Country | US
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Telephone | 404-769-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 750 HAMMOND DR STE 300
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City | ATLANTA
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State | GA
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Zip | 30328-5532
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Country | US
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Telephone | 404-769-2727
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MRS. ELISE S BERRYHILL
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Credential | LPC
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Telephone | 404-769-2727
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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 | LPC006780
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License Number State | GA
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