Provider Demographics
NPI:1235593286
Name:OVERCOMERS COUNSELING, LLC
Entity Type:Organization
Organization Name:OVERCOMERS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-518-5705
Mailing Address - Street 1:5003 KATHRYN GLEN DR
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-2018
Mailing Address - Country:US
Mailing Address - Phone:404-518-5705
Mailing Address - Fax:770-334-3674
Practice Address - Street 1:109 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3905
Practice Address - Country:US
Practice Address - Phone:404-518-5705
Practice Address - Fax:770-334-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008763101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty