Provider Demographics
NPI:1326712068
Name:PEACE AND PROSPERITY COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PEACE AND PROSPERITY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-538-4725
Mailing Address - Street 1:6361 TALOKAS LN STE C140
Mailing Address - Street 2:PMB 151
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-5645
Mailing Address - Country:US
Mailing Address - Phone:706-538-4725
Mailing Address - Fax:
Practice Address - Street 1:3575 MACON RD STE 2
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-8247
Practice Address - Country:US
Practice Address - Phone:706-538-4725
Practice Address - Fax:404-882-5352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty