Provider Demographics
NPI:1265637136
Name:SUDDENLY PROFESSIONAL COUNSELING & CONSULTING, P.C.
Entity Type:Organization
Organization Name:SUDDENLY PROFESSIONAL COUNSELING & CONSULTING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:RACHELLE
Authorized Official - Last Name:WINFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-305-8175
Mailing Address - Street 1:1044 BRIARBERRY LN
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-7102
Mailing Address - Country:US
Mailing Address - Phone:404-305-8175
Mailing Address - Fax:404-305-8176
Practice Address - Street 1:2227 GODBY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-5020
Practice Address - Country:US
Practice Address - Phone:404-305-8175
Practice Address - Fax:404-305-8176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002594251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health