Provider Demographics
NPI:1225459266
Name:COUNSELING WITH HEART, LLC
Entity Type:Organization
Organization Name:COUNSELING WITH HEART, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:BURT
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-449-9715
Mailing Address - Street 1:1275 SHILOH RD NW
Mailing Address - Street 2:SUITE 2770
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7175
Mailing Address - Country:US
Mailing Address - Phone:678-449-9715
Mailing Address - Fax:
Practice Address - Street 1:1275 SHILOH RD NW
Practice Address - Street 2:SUITE 2770
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7175
Practice Address - Country:US
Practice Address - Phone:678-449-9715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty