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General NPI Number Information
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NPI Number | 1922501576
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Entity Type | Organization
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Legal Business Name | ACORN CENTER FOR COUNSELING, GROWTH, & HEALING LLC
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Dates
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Enumeration Date | 03/09/2018
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Last Update Date | 03/09/2018
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Provider Practice Location Address
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Address Line | 942 NORTH AVE NE
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City | ATLANTA
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State | GA
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Zip | 30306-4466
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Country | US
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Telephone | 678-632-4554
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Fax |
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Provider Business Mailing Address
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Address Line | 942 NORTH AVE NE
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City | ATLANTA
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State | GA
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Zip | 30306-4466
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | REBECCA AHMADI
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Credential | LPC, RPT
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Telephone | 404-819-3850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC008726
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LPC008726
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | LPC008726
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License Number State | GA
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