Provider Demographics
NPI:1194394312
Name:REAL TALK LET'STALK COUNSELING, CONSULTING, AND COACHING
Entity Type:Organization
Organization Name:REAL TALK LET'STALK COUNSELING, CONSULTING, AND COACHING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-531-7953
Mailing Address - Street 1:4151 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-1504
Mailing Address - Country:US
Mailing Address - Phone:678-531-7953
Mailing Address - Fax:
Practice Address - Street 1:4151 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-1504
Practice Address - Country:US
Practice Address - Phone:678-531-7953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REAL TALK LET'STALK COUNSELING, CONSULTING, AND COACHING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty