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NPI Code Detail

MEDICARE: INTUITIVE COUNSELING ASSOCIATES LLC

MEDICARE: INTUITIVE COUNSELING ASSOCIATES 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1588315584
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTUITIVE COUNSELING ASSOCIATES LLC
Provider Business Mailing Address
First Line : 232 RIVER PARK NORTH DR
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-7834
Country : US
Telephone Number : 770-282-7116
Fax Number :
Provider Business Practice Location Address
First Line : 232 RIVER PARK NORTH DR
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-7834
Country : US
Telephone Number : 847-809-1228
Fax Number :
Authorized Official
Title or Position : PRACTICE OWNER/THERAPIST
Name : DR. JENNIFER R ROSE-HEFLIN
Credential : LPC
Telephone Number : 770-282-7116
Provider Enumeration Date : 01/12/2022
Last Update Date : 04/26/2022

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Directions to “INTUITIVE COUNSELING ASSOCIATES LLC ” Practice Location

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