Provider Demographics
NPI:1275044802
Name:ENAYA COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:ENAYA COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELING PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:WASIM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:678-313-2772
Mailing Address - Street 1:4470 MOSSBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4475
Mailing Address - Country:US
Mailing Address - Phone:678-313-2772
Mailing Address - Fax:
Practice Address - Street 1:5755 N POINT PKWY STE 79
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1146
Practice Address - Country:US
Practice Address - Phone:678-956-1733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004097261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health