MEDICARE: VISIONS OF LIFE COUNSELING AND CONSULTING

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	:	1801414487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISIONS OF LIFE COUNSELING AND CONSULTING

Provider Business Mailing Address
First Line	:	2692 HARRIS ST STE 101
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-2672
Country	:	US
Telephone Number	:	678-596-6703
Fax Number	:	678-948-2155

Provider Business Practice Location Address
First Line	:	2692 HARRIS ST STE 101
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-2672
Country	:	US
Telephone Number	:	678-381-7126
Fax Number	:	678-248-9155

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. VOLANDA TATE
Credential	:	MBA
Telephone Number	:	678-551-9198

Provider Enumeration Date	:	07/09/2020
Last Update Date	:	07/11/2020

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