Organization · NPI-2

Healthy Life Counseling

Clinic/Center, Adult Mental Health · Gainesville, GA

NPI number1295267268
StatusActive
Last updated in NPPESMar 29, 2017

Details

NPI
1295267268
Entity type
Organization (NPI-2)
Legal business name
Healthy Life Counseling
Organization subpart
No
Enumeration date
Mar 29, 2017
Last updated
Mar 29, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental HealthLPC009255GAYes
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)LPC009255GA
261QM0855X Clinic/Center, Adolescent and Children Mental HealthLPC009255GA

Practice location

2521 Mountain View Rd
Suite 4
Gainesville, GA 30504-5829

Phone 678-752-4335 · Fax 678-649-2101

Mailing address

2521 Mountain View Rd
Suite 4
Gainesville, GA 30504-5829

Phone 678-752-4335 · Fax 678-649-2101

Authorized official

Amanda Dutton
Owner
6787524335

Is something wrong?

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