Provider Demographics
NPI:1407598691
Name:GREATER DIMENSIONS COUNSELING & CONSULTING
Entity Type:Organization
Organization Name:GREATER DIMENSIONS COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TYSHON
Authorized Official - Middle Name:
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-670-1816
Mailing Address - Street 1:6450 EVANS DR UNIT 456
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-2710
Mailing Address - Country:US
Mailing Address - Phone:678-743-1987
Mailing Address - Fax:
Practice Address - Street 1:1811 SAINT IVES XING
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9011
Practice Address - Country:US
Practice Address - Phone:678-670-1816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty