MEDICARE: BRIGHTER OUTLOOK COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1578178034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTER OUTLOOK COUNSELING LLC

Provider Business Mailing Address
First Line	:	PO BOX 1012
Second Line	:
City	:	HAMPTON
State	:	GA
Zip	:	30228-0903
Country	:	US
Telephone Number	:	404-963-9511
Fax Number	:	404-806-9245

Provider Business Practice Location Address
First Line	:	3915 CASCADE RD SW STE 230
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-8520
Country	:	US
Telephone Number	:	404-963-9511
Fax Number	:	404-806-9245

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JOHNETTA L BARNES
Credential	:	LPC, NCC, CPCS
Telephone Number	:	404-963-9511

Provider Enumeration Date	:	09/11/2020
Last Update Date	:	09/21/2021

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