Provider Demographics
NPI:1326615485
Name:SUNLIGHT WELLNESS COUNSELING LLC
Entity Type:Organization
Organization Name:SUNLIGHT WELLNESS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC CLC
Authorized Official - Phone:678-231-5014
Mailing Address - Street 1:1115 BIG HAYNES DR
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017
Mailing Address - Country:US
Mailing Address - Phone:678-231-5014
Mailing Address - Fax:
Practice Address - Street 1:2208 MAIN ST E
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3498
Practice Address - Country:US
Practice Address - Phone:770-985-0837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARGIE PEDEN LPC CLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty