Provider Demographics
NPI:1437726965
Name:INFINITE LIFE COUNSELING
Entity Type:Organization
Organization Name:INFINITE LIFE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:T
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-903-2156
Mailing Address - Street 1:4644 POWDER SPRINGS DALLAS RD UNIT 1242
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-7710
Mailing Address - Country:US
Mailing Address - Phone:678-903-2156
Mailing Address - Fax:
Practice Address - Street 1:240 MEADOW CREST WAY
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-5772
Practice Address - Country:US
Practice Address - Phone:678-903-2156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty