Provider Demographics
NPI:1366849820
Name:PETRICHOR COUNSELING, LLC
Entity Type:Organization
Organization Name:PETRICHOR COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-617-9204
Mailing Address - Street 1:3460 SUMMIT RIDGE PKWY
Mailing Address - Street 2:STE 503
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3460 SUMMIT RIDGE PKWY
Practice Address - Street 2:STE 503
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1622
Practice Address - Country:US
Practice Address - Phone:678-617-9204
Practice Address - Fax:678-550-9093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-28
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007558101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty