Provider Demographics
NPI:1205223401
Name:GREATER LIVING COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:GREATER LIVING COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:202-409-7638
Mailing Address - Street 1:1900 S HAMPTON LN SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-3793
Mailing Address - Country:US
Mailing Address - Phone:202-409-7638
Mailing Address - Fax:
Practice Address - Street 1:1244 CLAIRMONT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1259
Practice Address - Country:US
Practice Address - Phone:202-409-7638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-25
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006945251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health