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General NPI Number Information
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NPI Number | 1962062695
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Entity Type | Organization
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Legal Business Name | CREDENCE COUNSELING, LLC
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 1530 DEKALB AVE NE STE A
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City | ATLANTA
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State | GA
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Zip | 30307-2175
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Country | US
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Telephone | 404-910-3085
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Fax | 404-393-1156
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Provider Business Mailing Address
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Address Line | 1530 DEKALB AVE NE STE A
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City | ATLANTA
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State | GA
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Zip | 30307-2175
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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 | OWNER
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Name | CHRISTOPHER FREEMAN
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Credential | LPC
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Telephone | 404-910-3085
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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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